engleski

Short and long-term outcomes of encephalitis

Background: The global incidence of encephalitis is 19.33 per 100, 000 person-years. A recent incidence decline, but rising mortality and disability have been noted. This study aimed to describe short and long-term outcomes of encephalitis of different etiologies. Methods: We retrospectively evaluated adult patients with encephalitis treated at the University Hospital for Infectious Diseases Zagreb, Croatia, 2014-2017. Short-term outcomes derived from medical records included length of hospitalization (LOH), Glasgow outcome score (GOS) at hospitalization and discharge. Long-term outcomes, including GOS and sequelae, were assessed by telephone interviews conducted in 2022. Results: Our study included 154 patients, 57.8% male, median age 50 (IQR 37-66.3) years. Etiologies were unknown (UE), viral, postinfectious, autoimmune (AE), bacterial (BE), tuberculous and fungal in 50.7%, 24.7%, 23.7%, 10.5%, 5.8%, 2.6% and 0.6%, respectively. Median LOH was 21 (IQR 13.75 – 32.25) days, 44.2% of patients had GOS≤3 and 6.5% died during hospitalization, 14.3% had a significant disability (GOS 2-3) and 79.2% had good outcomes (GOS 4-5) at discharge. There were 144 short-term survivors, of whom 63.9% were available for follow-up: 76.1% had good outcomes, 7.6% had significant sequelae, and 16.3% died. The most common sequelae were memory (33.8%), sensory (29.9%), concentration (27.3%) difficulties and headache (23.4%) ; 32.5% were asymptomatic. UE had the shortest LOH (17, IQR 12-26) and the least severe disabilities at discharge (10.26%), but most frequent long-term sequelae (14%). AE had the longest LOH (64.5, IQR 52.5-75.3), no deaths during hospitalization, most significant disabilities at discharge (25%), and best long- term outcomes (100%). BE caused the most deaths during hospitalization (22.2%). Conclusion: Short and long-term outcomes of encephalitis vary greatly with etiology. AE had excellent long-term, despite unfavorable short- term outcomes. A significant proportion of UE had adverse long-term outcomes. Our findings emphasize the need for new diagnostics to avoid UE and better rehabilitation for promising long-term outcomes.

Encephalitis ; outcome

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