Dugoročni ishodi u odraslih bolesnika s akutnim encefalitisom

master's thesis

• Title (english): Long-term outcomes of acute encephalitis in adults
• Author: Hana Panić
• Mentor: Marija Santini (mentor)
• Committee member: Dalibor Vukelić (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Marija Santini (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Encefalitis je upala moždanog parenhima koja može biti infektivne, postinfektivne ili
autoimune etiologije. Najučestaliji je infektivni encefalitis čiji uzročnici su najčešće virusi, a slijedi
ga akutni diseminirani encefalomijelitis (ADEM) i u najmanjem broju slučajeva autoimuni
encefalitis.
Glavni cilj rada je određivanje dugoročnog ishoda prema Modified Rankin Score-u (mRS) u
pacijenata liječenih od sindroma meningoencefalitisa u Zavodu za neuroinfektologiju i intenzivnu
medicinu Klinike za infektivne bolesti „Dr. Fran Mihaljević“ u 2014. i 2015. godini te usporediti
mRS svakog pacijenta u 2017. i 2022. godini.
Ovaj rad obuhvaća 90 pacijenata starijih od 18 godina koji su otpušteni iz Klinike pod
dijagnozom sindroma meningoencefalitisa. Podaci o tijeku hospitalizacije prikupljeni su iz
otpusnih pisama pacijenata. Podaci o dugoročnim ishodima prikupljeni su 2017. i 2022. godine
putem telefonskih poziva upućenih pacijentima, članovima njihove obitelji ili osobama sa kojima
žive. Temeljem prijavljenih tegoba određen je mRS za svakog pacijenta.
Prilikom obje telefonske kontrole najveći udio pacijenata prema Modified Rankin Scale
(mRS) pripada u kategoriju blage do umjerene onesposobljenosti (mRS 1, mRS 2 i mRS 3). Pri
prvoj kontroli taj udio iznosio je 44.3%, a pri drugoj kontroli 43.6%. Najizrazitije pogoršanje
simptoma između dvije kontrole primijećeno je u skupini pacijenata s preboljenim
postinfektivnim encefalitisom, dok je kod pacijenata s preboljenim encefalitisom nedokazane
etiologije pogoršanje tegoba najmanje izraženo. Nitko od praćenih pacijenata u razdoblju nakon
hospitalizacije nije razvio neurodegenerativnu bolest.
Razni čimbenici utječu na ishod pacijenata sa sindromom meningoencefalitisa od kojih su
najistaknutiji dob pacijenta, prisutnost komorbiditeta te etiologija bolesti. Uzevši u obzir ove
čimbenike, dugoročni ishodi pacijenata su izrazito raznovrsni te obuhvaćaju cijeli spektar
tegoba, od blažih poteškoća koncentracije do teških motoričkih i senzornih deficita.

Abstract (english)

Encephalitis is an inflammation of the brain parenchyma due to infective, postinfective or
autoimmune causes. Most frequently occurs infective encephalitis caused by viral infection,
followed by acute disseminated encephalomyelitis (ADEM) and the least common one is
autoimmune encephalitis.
The main goal of this study is to determine the long-term outcome, according to modified
Rankin score (mRS), in patients treated for meningoencephalitic syndrome in 2014 and 2015 in
University Hospital for Infectious Diseases „Dr. Fran Mihaljević “, Department for Adult Intensive
Care and Neuroinfections, and to compare mRS in each patient in 2017 and 2022.
This study includes 90 patients ≥18 years of age, who were discharged from the Hospital
with the diagnosis of meningoencephalitic syndrome. Hospital data were collected from
discharge letters. Data of long-term outcome were collected in 2017 and 2022 via two telephone
interviews with a patient, his/her family member or a person a patient is living with. Based on
patients’ symptoms, mRS was determined for each patient individually.
Both phone calls showed that most patients had mild to moderate disability (mRS 1, mRS 2
and mRS 3) according to Modified Rankin Score. In 2017 there were 44.3% and in 2022 43.6%
of patients with mild to moderate disability. The worst health deterioration, between two phone
calls, was observed in patients who had postinfectious encephalitis, while the patients who had
encephalitis of unknown etiology had the lightest progression of symptoms. None of the
observed patients have developed neurodegenerative disease during the time after
hospitalisation.
A lot of different factors have an influence on the outcomes of the patients with
meningoencephalitic syndrome, of whom the most distinctive are the patient’s age,
comorbidities and etiology of the disease. Regarding that, long-term outcomes in these patients
are extremely variable and include the whole spectrum of symptoms from mild concentration
problems to severe motor and sensor neurologic deficits.

• Keywords: meningoencefalitis; dugoročni ishodi; Modified Rankin Scale (mRS)
• Keywords (english): meningoencephalitis; long-term outcomes; Modified Rankin Scale (mRS)
• Language: croatian
• URN:NBN: urn:nbn:hr:105:477249
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-26 09:19:19