Abstract Details

Title A Retrospective Review on Encephalitis in the University of Colorado Health Care System and a Proposed Diagnostic Approach

Topic Infectious Disease

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-005

Objective To define current diagnostic testing and resource utilization patterns for patients hospitalized with encephalitis.

Background In the US, encephalitis results in >20,000 hospitalizations, over 1,000 deaths, and more than $2 billion in hospital charges yearly (Vora et al, 2014). Correctly and rapidly distinguishing between infectious and non-infectious causes of encephalitis is critical for early initiation of therapeutic interventions. A systematic, electronic medical record (EMR)-based diagnostic pathway may improve the accuracy and cost-effectiveness of diagnostic investigations in encephalitis. Here we present demographic, clinical and resource utilization data from patients hospitalized with encephalitis within a single, large hospital system over a twelve-month period. A proposed diagnostic pathway and prospective intervention study are additionally outlined.

Design/Methods This is a retrospective study identifying cases of encephalitis using ICD-10 codes from University of Colorado Hospital (UCH) system EMR for chart review. Cases identified within a 12-month period (01 June 2021 to 31 May 2022), are under review for analysis of key clinical and outcome measures.

Results A diagnosis of encephalitis was identified in 140 patients hospitalized during a twelve-month period preceding diagnostic pathway implementation. Patient ages ranged from 20 to 90 years (mean 57). There was equal division between sexes. 78% of patients were white, 14% were Black or African American, and 14% the race was unknown. All patients had a lumbar puncture performed. Magnetic resonance imaging of the brain was obtained for 43% of patients. Additional clinical and resource utilization data will be extracted and analyzed.

Conclusions The UCH system has a high volume of encephalitis cases accompanied by a high utilization of diagnostic testing. Analysis of clinical, outcome and resource utilization metrics may identify areas for improvement, allowing for rational design, implementation, and subsequent prospective study of an EMR-based diagnostic pathway to facilitate the rapid and cost-effective determination of encephalitis etiologies.

Authors/Disclosures
Madeline Garza, MD PRESENTER	Dr. Garza has nothing to disclose.
Elizabeth Matthews, MD	Dr. Matthews has nothing to disclose.
Brian M. Sauer, MD (University of Colorado)	The institution of Dr. Sauer has received research support from Annexon, Inc.. The institution of Dr. Sauer has received research support from Patient Centered Outcomes Research Center via Mayo Clinic. The institution of Dr. Sauer has received research support from Argenx. The institution of Dr. Sauer has received research support from NINDS & Amgen, Inc.. The institution of Dr. Sauer has received research support from Bristol Myers Squibb; Janssen Pharmaceutical Companies of Johnson & Johnson. The institution of Dr. Sauer has received research support from Hoffmann-La Roche. The institution of Dr. Sauer has received research support from UCB Biopharma SRL. Dr. Sauer has a non-compensated relationship as a Advisory Board Member, Neuroscience Advisor with Donor Alliance, Inc. that is relevant to AAN interests or activities.
Eric Engebretson (University of Colorado Denver)	Mr. Engebretson has nothing to disclose.
Brooke Valdez (University of Colorado)	Brooke Valdez has nothing to disclose.
Stefan Sillau	Stefan Sillau has nothing to disclose.
Aaron M. Carlson, MD (University of Colorado, School of Medicine, Department of Neurology)	Dr. Carlson has received research support from Horizon Therapeutics (Amgen).
Amanda L. Piquet, MD, FAAN (University of Colorado)	The institution of Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech/Roche. The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Kyverna . The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech/Roche. The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. The institution of Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Sands Anderson PC. Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Joe Jones Law Firm. Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Cortez & Associates. Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Falk Waas. The institution of Dr. Piquet has received research support from Rocky Mountain MS Center. The institution of Dr. Piquet has received research support from Roche/Genentech. The institution of Dr. Piquet has received research support from NYU. The institution of Dr. Piquet has received research support from Anokion. The institution of Dr. Piquet has received research support from UCB . The institution of Dr. Piquet has received research support from Foundation for Sarcoidosis. The institution of Dr. Piquet has received research support from Kyverna . Dr. Piquet has received publishing royalties from a publication relating to health care. Dr. Piquet has received publishing royalties from a publication relating to health care. Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving as a Litigative Consultant with US-Dept HHS/DICP. Dr. Piquet has a non-compensated relationship as a Medical Advisory Board Member with Autoimmune Encephalitis Alliance (AEA) that is relevant to AAN interests or activities. Dr. Piquet has a non-compensated relationship as a Medical Advisory Board Member with Stiff Person Syndrome Research Foundation (SPSRF) that is relevant to AAN interests or activities.

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