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抗 NMDAR、抗 LGI1 和抗 GABABR 脑炎患者的死亡危险因素。

Risk Factors for Mortality in Anti-NMDAR, Anti-LGI1, and Anti-GABABR Encephalitis.

机构信息

Department of Neurology, The First Hospital of Jilin University, Changchun, China.

Department of Hepatology, Second People's Clinical College of Tianjin Medical University, Tianjin, China.

出版信息

Front Immunol. 2022 Mar 7;13:845365. doi: 10.3389/fimmu.2022.845365. eCollection 2022.

Abstract

OBJECTIVE

We aimed to investigate the mortality rate and identify the predictors of death in patients with anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis.

METHODS

Patients with anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis were recruited from the Neurology Department of the First Hospital of Jilin University from March 2015 to November 2021. The primary outcome variable was a binary variable of death vs. survival. The potential risk factors for mortality were evaluated. The mortality rates were determined, and the independent predictors of death were identified using multivariable logistic regression analysis.

RESULTS

A total of 100 hospitalized patients with anti-NMDAR, anti-LGI1, or anti-GABABR encephalitis were included in the final analysis. Fifteen patients (15%) died during a median follow-up period of 18 months. The mortality rates were 10% for anti-NMDAR encephalitis, 2.8% for anti-LGI1 encephalitis, and 41.7% for anti-GABABR encephalitis. The multivariable analysis results showed that older age at onset [adjusted odds ratio (OR) = 1.017, 95% confidence interval (CI) = 1.009-1.136; = 0.023] was independently associated with an increased risk of death. Antibody type was also associated with mortality. Patients with anti-GABABR encephalitis had 13.458-fold greater odds of dying than patients with anti-LGI1 encephalitis (adjusted OR = 13.458, 95% CI = 1.270-142.631; = 0.031).

CONCLUSION

The general mortality rate of anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis was 15%. Age at onset and type of autoimmune encephalitis antibody were independent predictors of death in these patients.

摘要

目的

我们旨在研究抗 NMDAR、抗 LGI1 和抗 GABABR 脑炎患者的死亡率,并确定死亡的预测因素。

方法

本研究于 2015 年 3 月至 2021 年 11 月从吉林大学第一医院神经内科招募了抗 NMDAR、抗 LGI1 和抗 GABABR 脑炎患者。主要结局变量为死亡与存活的二分类变量。评估了潜在的死亡风险因素。确定死亡率,并使用多变量逻辑回归分析确定死亡的独立预测因素。

结果

共纳入 100 例抗 NMDAR、抗 LGI1 或抗 GABABR 脑炎住院患者进行最终分析。15 例(15%)患者在中位随访 18 个月期间死亡。抗 NMDAR 脑炎的死亡率为 10%,抗 LGI1 脑炎的死亡率为 2.8%,抗 GABABR 脑炎的死亡率为 41.7%。多变量分析结果显示,发病年龄较大[校正优势比(OR)=1.017,95%置信区间(CI)=1.009-1.136;=0.023]与死亡风险增加独立相关。抗体类型也与死亡率相关。与抗 LGI1 脑炎患者相比,抗 GABABR 脑炎患者死亡的可能性高 13.458 倍(校正 OR=13.458,95%CI=1.270-142.631;=0.031)。

结论

抗 NMDAR、抗 LGI1 和抗 GABABR 脑炎的总体死亡率为 15%。发病年龄和自身免疫性脑炎抗体类型是这些患者死亡的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d6/8934853/8b14dfd7b301/fimmu-13-845365-g001.jpg

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