title: Quality of life and associated socio-clinical factors after encephalitis in children and adults in England: a population-based, prospective cohort study.
abstract: OBJECTIVE
  We sought to measure HRQoL in all-cause encephalitis survivors and assess the impact of various socio-clinical factors on outcome.
  
  
  METHODS
  We used a prospective cohort study design, using the short-form 36 (SF-36) to measure the HRQoL in patients 15 years and older, and the short-form 10 (SF-10) for patients less than 15 years old. We posted questionnaires to individuals six months after discharge from hospital. All scores were normalised to the age- and sex-matched general population. We used multivariate statistical analysis to assess the relative association of clinical and socio-demographic variables on HRQoL in adults.
  
  
  RESULTS
  Of 109 individuals followed-up, we received 61 SF-36 and twenty SF-10 questionnaires (response rate 74%). Patients scored consistently worse than the general population in all domains of the SF-36 and SF-10, although there was variation in individual scores. Infectious encephalitis was associated with the worst HRQoL in those aged 15 years and over, scoring on average 5.64 points less than immune-mediated encephalitis (95% CI -8.77- -2.89). In those aged less than 15 years the worst quality of life followed encephalitis of unknown cause. Immuno compromise, unemployment, and the 35-44 age group all had an independent negative association with HRQoL. A poor Glasgow Outcome Score was most strongly associated with a poor HRQoL. Less than half of those who had made a 'good' recovery on the score reported a HRQoL equivalent to the general population.
  
  
  CONCLUSIONS
  Encephalitis has adverse effects on the majority of survivors' wellbeing and quality of life. Many of these adverse consequences could be minimised by prompt identification and treatment, and with better rehabilitation and support for survivors.
authors: Reference Microbiology Service, Public Health England, London, South London, United Kingdom; and Maudsley NHS Foundation Trust, London, United Kingdom.
authors: Parashar Pravin
authors: PP
authors: Ramanuj
authors: Virus Reference Department, Public Health England, London, United Kingdom.
authors: Julia
authors: J
authors: Granerød
authors: Department of Neurology, Chelsea & Westminster Hospital, London, United Kingdom.
authors: Nicholas W S
authors: NW
authors: Davies
authors: Statistics, Modelling and Economics Department, Public Health England, London, United Kingdom.
authors: Stefano
authors: S
authors: Conti
authors: Virus Reference Department, Public Health England, London, United Kingdom.
authors: David W G
authors: DW
authors: Brown
authors: Public Health Ontario, Ontario, Canada.
authors: Natasha S
authors: NS
authors: Crowcroft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004660:Encephalitis / Q000453:epidemiology* / Q000209:etiology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult