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Validation of the NEOS score in Chinese patients with anti-NMDAR encephalitis
Yujing Peng1, Feifei Dai1, Lei Liu1
1From the Department of Neurology, Beijing Tong Ren Hospital, Capital Medical University (Y.P., F.D., L. Liu, Y.L., C.L., L.C., Y.Z., L. Li, Q.M., J.W.); Medical Research Center, Beijing Tong Ren Hospital, Capital Medical University (Y.P., F.D., L. Liu, Y.L., C.L., L.C., Y.Z., L. Li, Q.M., J.W.); Department of Neurology, Beijing Tiantan Hospital, Capital Medical University (W.C., H.Y., X.Z.); Department of Neurology, Xuanwu Hospital, Capital Medical University (A.L.), Beijing; Beijing Children Hospital, Capital Medical University (X.W.); Department of Neurology, the Second Hospital of Hebei Medical University (J.H.), Shijiazhuang; China National Clinical Research Center for Neurological Diseases (W.C., H.Y.), Beijing; Center of Stroke, Beijing Institute for Brain Disorders (W.C., H.Y.); and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (W.C., H.Y.), China.
Objective:
The performance of anti-NMDAR Encephalitis One-Year Functional Status (NEOS) in predicting the 1-year functional status in Chinese patients with anti-NMDAR encephalitis is unknown.
Methods:
We recruited patients with anti-NMDAR encephalitis from the Multicenter and Prospective Clinical Registry Study of Anti-NMDAR Encephalitis in Beijing Area. Patients were followed up for 1 year. We defined the poor functional status as a modified Rankin Scale score of more than 2 and good functional status as a modified Rankin Scale score of no more than 2. We performed a receiver-operator characteristic analysis to assess the discriminatory power of the NEOS score in predicting the 1-year functional status by using the area under the curve (AUC). Calibration was assessed by Pearson correlation coefficient and Hosmer-Lemeshow tests.
Results:
Among the 111 patients with anti-NMDAR encephalitis recruited from 364 potentially eligible participants, 87 (78.4%) had good functional status at 1 year, whereas the remaining 24 (21.6%) had poor functional status. The AUC of the NEOS score for 1-year poor functional status was 0.86 (95% CI 0.78-0.93, p < 0.001). The increased NEOS was associated with higher risk of 1-year poor functional status in patients with anti-NMDAR encephalitis.
Conclusions:
The NEOS score is considered a reliable predictor of the risk of 1-year poor functional status in Chinese patients with anti-NMDAR encephalitis. This score could help to estimate the velocity of clinical improvement in advance.
Clinicaltrialgov Identifier:
NCT02443350.
Classification Of Evidence:
This study provides Class III evidence that in patients with anti-NMDAR encephalitis, the NEOS score predicts 1-year functional status.
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