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Caloric requirement targets for nutritional support in adult autoimmune encephalitis: a retrospective cohort study

Abstract

Background

Autoimmune encephalitis (AE) is a severe neurological disease often accompanied by consciousness disturbances, severe swallowing difficulties, and gastrointestinal dysfunction, increasing the risk of malnutrition. However, the optimal caloric intake target during the acute phase of AE remains unclear.

Objective

This study aims to evaluate the impact of caloric intake on short-term clinical outcomes in AE patients, specifically focusing on the improvement in Clinical Assessment Scale for Autoimmune Encephalitis (CASE) scores, to provide recommendations for nutritional support during the acute phase.

Methods

A retrospective study analyzed clinical data from 128 adult AE patients requiring nutritional support, admitted to West China Hospital, Sichuan University, from January 2020 to January 2024. Patients were categorized into low-calorie intake (below 70% of requirements), standard-calorie intake (70–100% of requirements), and high-calorie intake (above 100% of requirements) groups. Multivariate linear and logistic regression models were used to quantify the associations.

Results

Higher caloric intake was significantly associated with improved CASE scores (β = 8.58, SE = 3.75, 95% CI = 1.14 to 16.03, p = 0.02). Low caloric intake negatively impacted the improvement of CASE scores (p = 0.049), particularly in seizures and speech problems. The low-calorie intake group had significantly longer hospital stays and nutrition therapy durations (45.79 ± 30.98 days, p < 0.01; 40.39 ± 31.92 days, p = 0.02).

Conclusions

Adequate caloric intake has a significant positive impact on the short-term clinical outcomes of AE patients, suggesting that meeting or exceeding caloric requirements may promote neurological recovery in AE patients. Future prospective studies are needed to validate these findings and further optimize nutritional support strategies.

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Fig. 1: Recruitment flow chart for study participants.
Fig. 2: Correlation of CalorieRatio and days of mechanical ventilation with CASE ScoreDiff.
Fig. 3: Comparison of neurological symptoms by calorie intake groups.

Data availability

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank all participants for their participation in this study.

Funding

This work was supported by the National Natural Science Foundation of China (Grant Nos. 81571272 and 82071459) and Sichuan Province Science and Technology project (Grant No. 2019YFH0145).

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Author notes

  1. These authors contributed equally: Jia-Qi Wang, Yin-Ping Li.

Authors and Affiliations

  1. Neurology Department, West China Hospital, Sichuan University, Chengdu, China

    Jia-Qi Wang, Yin-Ping Li, Bo Yan & Jin-Mei Li

  2. Department of Neurology, Chengdu ShangJin NanFu Hospital, Chengdu, Sichuan, China

    Bo Yan

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  1. Jia-Qi Wang
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Contributions

JL and BY designed this study and revised the final version of the draft. JW and YL carried out this study; those authors collected samples, analyzed data, wrote the draft, and contributed equally to this study.

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Correspondence to
Bo Yan or Jin-Mei Li.

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The authors declare no competing interests.

Ethics approval and consent to participate

The Institutional Review Board of West China Hospital approved the study (IRB protocol number: ChiCTR1900027074). All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all participants involved in the study.

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Wang, JQ., Li, YP., Yan, B. et al. Caloric requirement targets for nutritional support in adult autoimmune encephalitis: a retrospective cohort study.
Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01537-2

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  • Received: 16 July 2024

  • Revised: 23 October 2024

  • Accepted: 28 October 2024

  • Published: 07 November 2024

  • DOI: https://doi.org/10.1038/s41430-024-01537-2

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