A Retrospective Review on Encephalitis in the University of Colorado Health Care System and a Proposed Diagnostic Approach (P8-10.005)

Abstract

<h3>Objective:</h3> To define current diagnostic testing and resource utilization patterns for patients hospitalized with encephalitis. <h3>Background:</h3> In the US, encephalitis results in &gt;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. <h3>Design/Methods:</h3> 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. <h3>Results:</h3> 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. <h3>Conclusions:</h3> 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. <b>Disclosure:</b> Dr. Garza has nothing to disclose. Dr. Matthews has nothing to disclose. Dr. Sauer has nothing to disclose. Mr. Engebretson has nothing to disclose. Ms. Valdez has a non-compensated relationship as a Valdez with The Rocky Mountain MS Center non-profit partner that is relevant to AAN interests or activities. The institution of Stefan Sillau has received research support from Alzheimer’s Association. The institution of Stefan Sillau has received research support from Hewitt Family Foundation; State of Colorado. The institution of Stefan Sillau has received research support from PCORI. The institution of Stefan Sillau has received research support from NINR. The institution of Stefan Sillau has received research support from Michael J. Fox Foundation. The institution of Stefan Sillau has received research support from Department of Defense. The institution of Stefan Sillau has received research support from Colorado Department of Public Health and Environment. The institution of Stefan Sillau has received research support from Benign Essential Blepharospasm Research Foundation. Stefan Sillau has a non-compensated relationship as a Statistician with Novartis that is relevant to AAN interests or activities. Stefan Sillau has a non-compensated relationship as a Statistician with Biogen that is relevant to AAN interests or activities. Dr. Carlson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. Carlson has received research support from Horizon Therapeutics. Dr. Carlson has a non-compensated relationship as a Health Service Subcommittee Member with American Academy of Neurology that is relevant to AAN interests or activities. The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. The institution of Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Piquet has received personal compensation in the range of $500-$4,999 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. The institution of Dr. Piquet has received research support from Rocky Mountain MS Center. The institution of Dr. Piquet has received research support from Novartis. The institution of Dr. Piquet has received research support from Abbvie. The institution of Dr. Piquet has received research support from Roche/Genentech. The institution of Dr. Piquet has received research support from NYU. 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.