| アブストラクト | BACKGROUND: Prompt initiation of anti-herpesvirus therapy is critical in managing herpes simplex virus encephalitis (HSE). However, real-world evidence on the impact of treatment timing remains limited. METHODS: We conducted a nationwide retrospective cohort study using the Diagnosis Procedure Combination (DPC) database in Japan from July 2010 to March 2023. Patients with HSE who received intravenous anti-herpesvirus therapy during hospitalization were included. Patients were classified into early (initiated on admission day) and delayed (day 2 or later) treatment groups. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline differences. The primary outcome was in-hospital mortality; secondary outcomes included the composite outcome of death or impaired consciousness at discharge, impaired functional status (Barthel Index <90), total hospitalization cost, and length of stay. RESULTS: Of 6788 patients, 4368 (64.3%) received anti-herpesvirus therapy on admission day. After IPTW, early treatment was associated with lower in-hospital mortality (odds ratio, 0.51; 95% confidence interval, 0.41-0.62), reduced composite poor outcome (0.70; 0.63-0.78), reduced Barthel Index <90 (0.62; 0.56-0.69), reduced hospitalization cost (-310,000 yen; -403,000 to -216,000), and reduced length of stay (-8.3 days; -10.7 to -5.9). CONCLUSION: Early anti-herpesvirus therapy was associated with improved survival, functional outcomes, and lower resource utilization in HSE. |
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| ジャーナル名 | International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases |
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| Pubmed追加日 | 2025/7/29 |
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| 投稿者 | Kutsuna, Satoshi; Ohbe, Hiroyuki; Kimura, Yuya; Shinmoto, Keito; Matsuo, Yuichiro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Infection Control, Graduate School of Medicine Faculty of Medicine,;Center for Infectious Disease Education and Research, Osaka University,;Suita-shi, Osaka, Japan.;Department of Emergency and Critical Care Medicine, Tohoku University Hospital,;Aoba-ku, Sendai, Japan; Department of Clinical Epidemiology and Health Economics,;School of Public Health, The University of Tokyo, Tokyo, Japan. Electronic;address: hohbey@gmail.com.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center,;Urayasu, Chiba, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Institute of Science Tokyo Graduate;School of Medicine, Tokyo, Japan.;Aoba-ku, Sendai, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40721169/ |
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