Outcomes of Critically Ill Adult Patients With Acute Encephalitis

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• Functional outcomes and long-term recovery after severe encephalitis are not well characterized.
• Severe encephalitis poses significant challenges for patient recovery and long-term prognosis.

Purpose of the Study:

• To determine the incidence of functional disability or death at 3 months post-encephalitis.
• To describe functional recovery trajectories through 1 year following encephalitis.

Main Methods:

• Prospective multicenter cohort study involving 310 adults with severe encephalitis requiring intensive care.
• Categorization of encephalitis causes into infectious, autoimmune, other, and unknown origins.
• Assessment of functional outcomes using the modified Rankin scale at 3 months and 1 year.

Main Results:

• Over half of patients (51.9%) experienced an unfavorable outcome at 3 months, including 27.1% mortality.
• Age and immunocompromised status were associated with unfavorable outcomes, while intravenous acyclovir was linked to favorable outcomes.
• Functional independence remained stable from 3 months to 1 year, but autoimmune encephalitis patients showed significant improvement.

Conclusions:

• Severe encephalitis leads to significant disability or death in approximately half of patients within 3 months.
• Long-term functional recovery varies by encephalitis etiology, with autoimmune cases demonstrating better outcomes.
• Targeted long-term support may improve outcomes for specific encephalitis patient groups.