• Jesse Cohen, Javier Sotoca, Shikha Gandhi, Anusha K Yeshokumar, Eliza Gordon-Lipkin, Romergyko G Geocadin, Kevin D Frick, John C Probasco, and Arun Venkatesan.
• From the Johns Hopkins Encephalitis Center (J.C., S.G., E.G.-L., R.G.G., J.C.P., A.V.), Department of Neurology, and Departments of Neurosurgery and Anaesthesia/Critical Care (R.G.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Neurology Department (J.S.), IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Neurology and Pediatrics (A.K.Y.), Icahn School of Medicine at Mt. Sinai, New York, NY; Department of Neurology and Developmental Medicine (E.G.-L.), Kennedy Krieger Institute; and Johns Hopkins Carey Business School (K.D.F.), Baltimore MD.
• Neurology. 2019 Feb 26; 92 (9): e964-e972.

ObjectiveTo assess the inpatient hospitalization burden and costs of patients with autoimmune encephalitis (AE) at a tertiary care institution.MethodsAdult inpatients with AE were identified retrospectively from July 1, 2005, to June 30, 2015. Demographic and clinical data were collected and analyzed. Billing data were compared to those of patients with herpes simplex encephalitis (HSE). Charges were adjusted for inflation.ResultsOf 244 admissions for encephalitis reviewed, 63 patients met criteria for probable or definite AE. Thirty-one (49%) patients were antibody positive, and 27 (43%) were admitted to the intensive care unit (ICU). Median hospital charges per patient with AE were more than $70,000; median length of stay (LOS) was 15 days; and in-hospital mortality was 6%. Patients admitted to the ICU had substantially higher median hospital charges (ICU $173,000 per admission vs non-ICU $50,000 per admission, p < 0.001). LOS was strongly associated with charges and was driven by delay in diagnosis of AE, prolonged treatment courses, and lack of response to therapy. Compared with HSE, median hospital charges per patient with AE were nearly 4 times higher, median AE LOS was 3 times higher, and total charges over the study period were nearly twice as high.ConclusionsPatients with AE used more inpatient health care resources per patient during a 10-year period than patients with HSE at our institution. ICU-admitted patients with AE were responsible for a substantially higher financial burden than non-ICU-admitted patients with AE. Our data underscore the need for the development of novel diagnostic and therapeutic modalities to improve patient outcomes and to decrease hospital burden in AE.© 2019 American Academy of Neurology.

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