Research Article

Risk Prediction Models for Invasive Mechanical Ventilation in Patients with Autoimmune Encephalitis: A Retrospective Cohort Study

Table 1

Characteristics of patients with AE.

CharacteristicsAllNo IMV patientsIMV patientsP-value
(N = 153)(N = 104)(N = 49)

Gender (male/female)83/7065/3918/310.003
Age, years50.22 ± 17.4951.18 ± 15.9148.18 ± 18.590.324
Positive antibody, n (%)<0.001
 NMDAR53 (34.6)31 (29.8)22 (44.9)
 GAD 656 (3.9)6 (5.8)0 (0)
 LGI152 (33.9)44 (42.3)8 (16.3)
 GABABR25 (16.3)12 (11.5)13 (26.5)
 AMPAR6 (3.9)0 (0)6 (12.2)
 CASPR26 (3.9)6 (5.8)0 (0)
 MOG5 (3.3)5 (4.8)0 (0)
Antibody subtype, n (%)<0.001
 Anti-intracellular antigen6 (3.9)6 (5.8)0 (0)
 Anti-synaptic receptors84 (54.9)43 (41.3)41 (83.7)
 Anti-ion channels & other surface proteins63 (41.2)55 (52.9)8 (16.3)
Clinical Subtype, n (%)0.024
 Anti-NMDAR encephalitis53 (34.6)31 (29.8)22 (44.9)
 Limbic encephalitis89 (58.2)62 (59.6)27 (55.1)
 Other AE syndrome11 (7.2)11 (10.6)0 (0)
Blood CBA, n (%)0.054
 negative21 (13.7)18 (17.3)3 (6.1)
 +72 (47.1)47 (45.2)25 (51.0)
 ++36 (23.5)27 (26.0)9 (18.4)
 +++24 (15.7)12 (11.5)12 (24.5)
CSF CBA, n (%)<0.001
 Negative11 (7.2)6 (5.8)5 (10.2)
 +9 (5.9)9 (8.7)0 (0)
 ++43 (28.1)38 (36.5)5 (42.9)
 +++90 (58.8)51 (49.0)39 (46.9)
Clinlcal symptom, n (%)
 Epilepsy128 (83.7)87 (83.7)41 (83.7)1.000
 Short-term memory dysfunction129 (84.3)81 (77.9)48 (98.0)0.001
 Calculation dysfunction122 (79.7)75 (72.1)47 (95.9)<0.001
 Psychiatric symptoms91 (59.4)58 (55.8)33 (67.3)0.217
 Consciousness disorders21 (13.7)4 (3.8)17 (34.7)<0.001
 Language dysfunction84 (54.9)50 (48.1)34 (69.4)0.015
 Extrapyramidal symptoms41 (26.8)22 (21.2)19 (38.8)0.031
 Autonomic dysfunction53 (34.6)35 (33.7)18 (36.7)0.719
Interval from symptoms onset to hospital admission (months), n (%)0.216
 ≤190 (58.8)59 (56.7)31 (63.3)
 1–343 (28.1)28 (26.9)15 (30.6)
 >320 (13.1)17 (16.3)3 (6.1)
Thyroid function tests
 TPOAb, n (%)43 (28.1)27 (26.0)16 (32.7)0.442
 TGAb, n (%)54 (35.3)34 (32.7)20 (40.8)0.367
 FT3 (2.63–5.7) pmol/L3.58 ± 1.043.70 ± 3.333.33 ± 0.930.042
 FT4 (9.01–19.05) pmol/L13.22 ± 2.5913.21 ± 2.2613.23 ± 3.210.974
 TSH (0.35–4.94) mlU/L1.73 ± 2.081.82 ± 2.041.54 ± 2.160.456
CSF test
 ICP (80–180) mmH2O164.61 ± 60.96153.70 ± 51.89187.76 ± 72.030.004
 CSF protein (120–600) mg/L622.15 ± 452.25600.52 ± 400.27668.08 ± 535.560.390
 CSF Glucose (2.2–3.9) mmol/L3.79 ± 1.063.82 ± 1.003.72 ± 1.190.593
 CSF Cl (120–132) mmol/L119.71 ± 5.53119.23 ± 4.97120.72 ± 6.510.120
 CSF cell (0–15)109/L44.12 ± 83.1933.78 ± 86.2466.08 ± 73.320.025
Blood tests
 CRP (0–6) mg/L30.14 ± 50.6819.67 ± 41.952.36 ± 60.210.001
 ESR (0–20) mm/h18.24 ± 18.1315.59 ± 15.4623.86 ± 20.310.015
 CEA (0–4.3) ng/mL3.28 ± 3.563.25 ± 3.963.34 ± 2.560.884
 AFP (0–7) ng/mL2.85 ± 1.622.95 ± 1.632.63 ± 1.600.248
 CA125 (0–35) U/mL16.52 ± 18.5015.78 ± 21.1218.07 ± 11.070.476
 CA153 (0–25) U/mL9.05 ± 4.269.41 ± 4.288.28 ± 4.170.128
 CA199 (0–27) U/mL14.83 ± 14.0615.14 ± 15.7114.18 ± 9.820.696
 NSE (0–16.3) ng/mL14.80 ± 5.6614.61 ± 4.7215.18 ± 7.300.563
Comorbidities, n (%)
 Impaired hepatic function46 (30.1)20 (19.2)26 (53.1)<0.001
 Pulmonary infection73 (47.7)27 (26.0)46 (93.9)<0.001
Therapy, n (%)
 Corticosteroids138 (90.2)94 (90.4)44 (89.8)1.000
 Immunoglobulin49 (32.0)21 (20.2)28 (57.1)<0.001
EEG, n (%)83 (54.2)52 (50)31 (63.3)0.164
MRI, n (%)70 (45.8)57 (54.8)13 (26.5)0.002

Note: IMV, invasive mechanical ventilation; AE, autoimmune encephalitis; NMDAR, N-methyl-D-aspartate receptor; MOG, myelin-oligodendrocyte glycoprotein; LGI 1, leucine-rich glioma-inactivated 1; GAD 65, glutamic acid decarboxylase antibody 65; GABABR, γ-aminobutyric acid type B receptor; CASPR2, contactin-associated protein-like 2; AMPAR, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors; CBA, cytometric bead assay; CSF, cerebral spinal fluid; TPOAb, thyroid peroxidase antibody; TGAb, thyroglobulin antibody; FT3, free triiodothyronine; FT4, free thyroxine; TSH, thyrotropin; ICP, ICP, intracranial pressure; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; CEA, carcinoembryonic antigen; AFP, alpha fetal protein; CA125, carbohydrate antigen 125; NSE, neuron-specific enolase; MRI, agnetic resonance imaging; EEG, electroencephalography.