Abstract Details

Title Racial and Ethnic Disparities in the Clinical Outcomes of Patients with Encephalitis

Topic Health Care Disparities

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-011

Background Encephalitis is an inflammation of the brain caused by several infectious or non-infectious etiologies (e.g., autoimmune encephalitis). The influence of racial disparities in autoimmune disease outcomes, such as multiple sclerosis, is established in current literature.

Objective

To determine if there are significant differences in clinical outcomes between encephalitis patients of different racial and ethnic backgrounds.

Design/Methods A retrospective cohort study was conducted using electronic health records in Greater Houston and Baltimore areas between 2005 and 2022. Patients were dichotomized by race into non-Hispanic Whites and ethnic minorities. A bivariate analysis was used for dichotomous clinical features, while median was used for continuous variables.

Results

Of the 601 patients, 313 were non-Hispanic White (52.1%) and 288 were of an ethnic minority (47.9%). Ethnic minority patients were significantly younger (median 44 vs 56; p = <.001), with a higher proportion of abnormal electroencephalograms (EEG) compared to non-Hispanic Whites (84% v 72.1%; p = .005). Ethnic minority patients had a higher incidence of autoimmune encephalitis (24% vs 16.7%; p = .042). Non-Hispanic Whites were more likely to present with memory deficits (36.7% vs 26.7%; p = .01). Ethnic minority patients had worse Sequential Organ Failure Assessments (SOFA) (44.2% with SOFA >3 vs 34.4%; p = .025) and Full Outline of UnResponsiveness Scores (FOUR Score) (28.6% with FOUR Score <14 vs 20.4%; p = .026) at presentation. A higher proportion of non-Hispanic Whites had worse outcomes on the Glasgow Outcome Scale (GOS) (76.5% with GOS <5 vs 50.2%; p = <.001), and significantly more ethnic minority patients were alive post-treatment (73.2% vs 44%; p = <.001).

Conclusions

We found significant differences between non-Hispanic White and ethnic minority encephalitis patients in age, EEGs, presenting signs, and patient outcomes. Further work is needed to determine the role of age as a confounding variable in patient outcomes.

Authors/Disclosures
Sienna Wu PRESENTER	Ms. Wu has nothing to disclose.
Rodrigo Hasbun	No disclosure on file
Arun Venkatesan, MD, PhD (Johns Hopkins Hospital)	Dr. Venkatesan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Pharmaceuticals. The institution of Dr. Venkatesan has received research support from NIH. The institution of Dr. Venkatesan has received research support from MSRCF. The institution of Dr. Venkatesan has received research support from U.S. DOD.
John Probasco, MD, FAAN (The Johns Hopkins Hospital)	Dr. Probasco has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch Neurology. The institution of Dr. Probasco has received research support from Roche/Genentech.
Laya Rao (Villas at Hermann Park)	Ms. Rao has nothing to disclose.
Paris Bean	No disclosure on file
Ralph Habis, MD (Johns Hopkins School of Medicine)	Dr. Habis has nothing to disclose.
Ashley Heck	No disclosure on file
Rajesh K. Gupta, MBBS (UTHealth)	Dr. Gupta has nothing to disclose.