Complications, outcomes, and implications of a prolonged vegetative state in anti-NMDA receptor encephalitis: a retrospective international cohort study - PubMed
5 hours ago
- #prolonged vegetative state
- #immunotherapy outcomes
- #anti-NMDA receptor encephalitis
- Study focuses on prolonged vegetative state in anti-NMDA receptor encephalitis patients.
- 45 patients from 21 hospitals across multiple countries were analyzed.
- Median age of patients was 22 years, with 38 females and 7 males.
- All patients received first-line immunotherapy; 91% received second-line, and 40% received third-line therapies.
- 47% of patients had ovarian teratomas, with 20 undergoing removal.
- Median durations: vegetative state (399 days), ICU stay (275 days), mechanical ventilation (270 days), hospitalization (474 days).
- 28% of patients were resuscitated from dysautonomic cardiac arrest.
- After 5 years, 33% completely recovered, 29% substantially improved, 24% had moderate to severe disability, and 13% died.
- Teratomas were associated with lower probability of substantial improvement.
- Older age and higher NEOS2 score were linked to increased mortality.
- Two-thirds of patients achieved full or substantial recovery, suggesting delayed improvement is possible.
- Futility decisions should be individualized with multidisciplinary input and extended follow-up.