Validation Of The CASE And NEOS In Autoimmune Encephalitis And Explore The Prognostic Biomarkers

Objectives: The CASE and NEOS are scales for assessing the severity of autoimmune encephalitis.We aimed to validate the CASE and NEOS scores in a Chinese population.And investigate whether the NLR can evaluate the severity of AE.Methods: Patients diagnosed with autoimmune encephalitis were recruited between June 2014 and May 2019 from two hospitals.CASE,NEOS and modified Rankin Scale(m RS)scores were obtained.Compare the advantages of the CASE and NEOS scales and evaluate whether NLR can assess the severity of AE.Data regarding clinical features,treatment,and available information were gathered from the hospital information system.Results: Of the 176 patients with autoimmune encephalitis,11 died and 14 had tumors.27(15.34%)relapsed.Ten patients received second-line treatment.The CASE scores of patients receiving second-line treatment were significantly higher(median CASE: 15)than those receiving first-line treatment(median CASE: 8)(p<0.001).Twenty-two patients had poor functional status(m RS>2).Areas under the curve of CASE on whether functional status was poor at one year were 0.89(p<0.001).Sixty patients were admitted to the intensive care unit(ICU),and the CASE scores were positively correlated with days in the ICU(r=0.58,p<0.001).NEOS score is associated with AE relapse(p=0.037<0.05).There was no statistically significant association between the CASE scores and relapse(p=0.39>0.05).Additionally,the CASE scores were positively associated with the m RS scores(r=0.85p<0.001).NLR was significantly higher in AE patients with m RS>3compared to AE patients with m RS≤3 at admission(median:5.80vs4.01,p=0.0181<0.05),and NLR was positively correlated with m RS score(r=0.365,p=0.037<0.05).Conclusions: The CASE score is suitable for the comprehensive assessment of Chinese patients with autoimmune encephalitis,which may help clinicians to select the appropriate intervention and estimate the disease severity and prognosis.A higher NEOS score suggests a higher risk of recurrence.Peripheral blood NLR levels can be used as a biomarker to predict the progression of disease in AE.