Functional outcomes in adult patients with herpes simplex encephalitis admitted to the ICU: a multicenter cohort study
Abstract
Purpose We aimed to study the association of body temperature and other admission factors with outcomes of herpes simplex encephalitis (HSE) adult patients requiring ICU admission.Methods We conducted a retrospective multicenter study on patients diagnosed with HSE in 47 ICUs in France, between 2007 and 2017. Fever was defined as a body temperature higher or equal to 38.3 °C. Multivariate logistic regression analysis was used to identify factors associated with poor outcome at 90 days, defined by a score of 3-6 (indicating moderate-to-severe disability or death) on the modified Rankin scale.Results Overall, 259 patients with a score on the Glasgow coma scale of 9 (6-12) and a body temperature of 38.7 (38.1-39.2) °C at admission were studied. At 90 days, 185 (71%) patients had a poor outcome, including 44 (17%) deaths. After adjusting for age, fever (OR = 2.21; 95% CI 1.18-4.16), mechanical ventilation (OR = 2.21; 95% CI 1.21-4.03), and MRI brain lesions > 3 lobes (OR = 3.04; 95% CI 1.35-6.81) were independently associated with poor outcome. By contrast, a direct ICU admission, as compared to initial admission to the hospital wards (i.e., indirect ICU admission), was protective (OR = 0.52; 95% CI 0.28-0.95). Sensitivity analyses performed after adjustment for functional status before admission and reason for ICU admission yielded similar results.Conclusions In HSE adult patients requiring ICU admission, several admission factors are associated with an increased risk of poor functional outcome. The identification of potentially modifiable factors, namely, elevated admission body temperature and indirect ICU admission, provides an opportunity for testing further intervention strategies.
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Mortality rates in HSV-1 encephalitis have dropped below 20%.
“Mortality rates have dropped below 20% [34, 57].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [57]
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- Authors
- ENCEPHALITICA study group, Jaquet, P., de Montmollin, E., Dupuis, C., Sazio, C., Conrad, M., Susset, V., Demeret, S., Tadie, J. M., Argaud, L., Barbier, F., Sarton, B., Chabane, R., Daubin, D., Brulé, N., Lerolle, N., Alves, M., Da Silva, D., Kalioubi, A. E., Silva, S., Bailly, P., Wolff, M., Bouadma, L., Timsit, J. F., & Sonneville, R.
- Affiliations
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre Hospitalier Universitaire de Bordeaux (FR)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- Hôpital Edouard Herriot (FR)
- Hôpital Purpan (FR)
- Centre Hospitalier Universitaire de Clermont-Ferrand (FR)
- Centre Hospitalier Universitaire de Montpellier (FR)
- Centre Hospitalier Universitaire de Nantes (FR)
- Centre Hospitalier Intercommunal de Poissy (FR)
- Hôpital Roger Salengro (FR)
- Inserm (FR)
- Corresponding author
- Sonneville, R.
- ORCID
- Venue
- Intensive Care Medicine
- Published
- 2019-07-10
- Volume
- 45
- Issue
- 8
- Pages
- 1103-1111
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W2961838634
- Cited by
- 52
- References
- 31
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 12 · 2023: 11 · 2022: 4 · 2021: 5 · 2020: 9 · 2019: 1
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Update notices
- correction (2019-07-25)
- Open access
- closed
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
- Keywords
- herpes simplex encephalitis, functional outcome, body temperature, fever, mechanical ventilation, brain MRI lesions, modified Rankin Scale, adult patients, risk factors for poor outcome
- MeSH terms
- Physical Functional Performance, Aged, Female, France, Hospitalization, Humans, Intensive Care Units, Male, Middle Aged, Retrospective Studies, Cohort Studies, Outcome Assessment, Health Care, Encephalitis, Herpes Simplex
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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