Autoimmune encephalitis: a costly condition

Objective: To assess the inpatient hospitalization burden and costs of patients with autoimmune encephalitis (AE) at a tertiary care institution. Methods: Adult inpatients with AE were identified retrospectively from July 1, 2005 – June 30, 2015. Demographic and clinical data were collected and analyzed. Billing data were compared to that of patients with herpes simplex encephalitis (HSE). Charges were adjusted for inflation. Results: Of 244 admissions for encephalitis reviewed, 63 patients met criteria for probable or definite AE. Thirty-one (49%) patients were antibody-positive, and twenty-seven (43%) were admitted to the intensive care unit (ICU). Median hospital charges per AE patient were over $70k, median length of stay (LOS) was 15 days, and in hospital mortality was 6%. ICU patients had substantially higher median hospital charges (ICU $173k/ admission vs. non-ICU $50k/ admission, p<0.001). LOS was strongly associated with charges and was driven by delay in diagnosis of AE,...