Abstract Details

Title Sociodemographic Factors Associated with Clinical Outcomes in CNS Inflammatory and Infectious Diseases: A Retrospective Cohort Study

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-076

Objective Evaluate sociodemographic factors associated with outcome in patients with neuroinflammatory and neuroinfectious diseases admitted to an urban tertiary care center.

Background CNS inflammatory and infectious disorders carry significant morbidity and mortality. Little data exists on sociodemographic factors associated with functional disability and mortality in this population.

Design/Methods A retrospective analysis of encephalitis, meningitis and myelitis cases at Columbia University Medical Center was performed. Sociodemographic variables were collected for patients over 16 years old. Multivariate logistic regression analysis of sociodemographic factors associated with outcome (good outcome defined as Glasgow Outcome Score=5) was performed.

Results 357 patients newly diagnosed with encephalitis, meningitis and myelitis as defined by the Brighton Collaboration were analyzed. Median age was 40 years (IQR 23) with 308 patients over 16 years old (86%) and 176 (49.3%) male patients. 170 (48%) patients satisfied criteria for encephalitis, 57 (16%) for meningitis, and 53 (15%) for myelitis. 189 (53%) cases were of unknown etiology, 99 (28%) cases identified an immune-mediated cause and 67 (19%) cases an infectious pathogen. In our multivariate analysis, African American patients were less likely to present with encephalitis (OR 0.386, p=0.028) and more likely with meningitis (OR 3.574, p=0.0097). Male gender (OR 2.172, p=0.027) and age (OR 1.024, p=0.016) were associated with neuroinfectious pathogens, while female gender trended towards increased immune-mediated causes (OR 1.71, p=0.071). Older patients were less likely to have good outcomes at discharge (OR 0.985, p=0.0486). Active smoking was associated with lower likelihood of good outcomes in patients with encephalitis (OR 0.244, p=0.01) and those with immune-mediated causes (OR=0.176 p=0.0186); conversely, active alcohol users were more likely to have good discharge outcomes (OR 3.734, p=0.043).

Conclusions Our study suggests older age is associated with poor outcome across all neuroinfectious and neuroinflammatory patients, while active smoking is a predictor of poor outcome in patients with encephalitis and immune-mediated causes.

Authors/Disclosures
Dan Tong Jia, MD PRESENTER	Dr. Jia has nothing to disclose.
Alexandra Boubour	Ms. Boubour has received research support from The Fulbright Program.
	No disclosure on file
Kathryn T. Fong, MD (Swedish Multiple Sclerosis Center)	Dr. Fong has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Fong has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Fong has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Fong has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Fong has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TG Therapeutics.
Gen Li (PhESi)	No disclosure on file
	No disclosure on file
Kiran Thakur, MD, FAAN (Columbia University College of Physicians and Surgeons)	Dr. Thakur has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Delve Bio.

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