Racial and Ethnic Disparities in Clinical Characteristics and Outcomes in Adults With Encephalitis: A Retrospective Study

Authors

• Sienna Wu
• Rodrigo Hasbun
• Ralph Habis
• Jordan Benderoth
• Ivany Patel
• Ashutosh Gupta
• Megan Goyal
• Arun Venkatesan
• John C Probasco
• Paris Bean
• Ashley Heck
• Laya Rao
• Rajesh K Gupta

Language

English

Publication Date

1-1-2026

Journal

Journal of Central Nervous System Disease

DOI

10.1177/11795735251414833

PMID

41552814

PMCID

PMC12811602

PubMedCentral® Posted Date

1-15-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Background and objectives: This study aims to assess whether adult patients with encephalitis from different racial and ethnic backgrounds exhibit significant differences in clinical presentation, diagnostic findings, and outcomes.

Design and methods: A retrospective cohort study was conducted by utilizing the electronic health records of encephalitis patients in the greater Houston and Baltimore areas. Patients were categorized by race/ethnicity into White or ethnic minority (including Black, Hispanic, and Asian patients). Data was analyzed for the presence of significant differences in clinical characteristics between the two groups.

Results: Among 599 patients, 312 (52.1%) were White and 287 (47.9%) were of an ethnic minority. White patients were more often over sixty years-old upon presentation (43.1% vs 23.9%, P < 0.001) and more likely to present with memory deficits (36% vs 26.3%, P = 0.012). Ethnic minority patients more frequently presented with co-existing HIV (20.3% vs 3.4%, P < 0.001), severe organ dysfunction (44% vs 34.4%, P = 0.028), cerebrospinal fluid (CSF) pleocytosis (white blood cell count ≥5 cells/µL) (83.1% vs 69.3%, P < 0.001), and abnormal electroencephalogram (EEG) findings (84.3% vs 71.9%, P = 0.035). Ethnic minority patients also had worse outcomes on the Glasgow Outcome Scale (GOS) as defined by GOS < 4 (59.3% vs 47.2%, P = 0.005). Binary logistic regression identified abnormal magnetic resonance imaging (MRI) and Glasgow Coma Scale (GCS) < 13 as independent predictors of an adverse clinical outcome (GOS < 4) with an adjusted odds ratio [95% confidence interval] (P value) of 1.609 [1.042-2.486] (P = 0.032) and 2.689 [1.675-4.317] (P < .001), respectively.

Conclusion: Ethnic minority patients with encephalitis present at a younger age and are more likely to have co-existing HIV, severe initial organ dysfunction, CSF pleocytosis, abnormal EEG findings, and worse clinical outcomes. Abnormal MRI and GCS < 13 are independent predictors of an unfavorable clinical outcome and may aid in risk stratification.

Keywords

racial disparities, encephalitis, infectious encephalitis, autoimmune encephalitis, socioeconomic disparities

Published Open-Access

yes

Recommended Citation

Wu, Sienna; Hasbun, Rodrigo; Habis, Ralph; et al., "Racial and Ethnic Disparities in Clinical Characteristics and Outcomes in Adults With Encephalitis: A Retrospective Study" (2026). Faculty, Staff and Student Publications. 3592.
https://digitalcommons.library.tmc.edu/uthmed_docs/3592