Recovery Assessment Following West Nile Virus Encephalitis

Description

Klee et al evaluated the outcome of patients after West Nile Virus encephalitis. This can help determine the extent of recovery following the infection. The authors are from the New York City of Health and Centers for Disease Control and Prevention.

Measurements:

(1) baseline, before clinical onset

(2) after recovery (6, 12, or 18 months or longer)

Parameters:

(1) physical health (9 measures)

(2) cognitive health (6 measures)

(3) functional health (9 measures)

Physical Health	Finding	Points
difficulty walking	never	0
	sometimes	2
	always	4
fatigue	never	0
	sometimes	1
	always	2
headache	never	0
	sometimes	1
	always	2
insomnia	never	0
	sometimes	1
	always	2
joint pain	never	0
	sometimes	1
	always	2
muscle pain	never	0
	sometimes	1
	always	2
muscle weakness	never	0
	sometimes	1
	always	2
seizures	never	0
	sometimes	1
	always	2
stiff neck	never	0
	sometimes	1
	always	2

where:

• Difficulty walking was scored higher than other measures since it correlates with more severe disease.

Cognitive Health	Finding	Points
confusion	never	0
	sometimes	1
	always	2
depression	never	0
	sometimes	1
	always	2
irritability	never	0
	sometimes	1
	always	2
lightheadedness	never	0
	sometimes	1
	always	2
loss of concentration	never	0
	sometimes	1
	always	2
loss of memory	never	0
	sometimes	1
	always	2

Functional Health	Finding	Points
heavy chores	no disability	0
	mild disability	1
	significant disability	2
laundry	no disability	0
	mild disability	1
	significant disability	2
light housekeeping	no disability	0
	mild disability	1
	significant disability	2
managing medications	no disability	0
	mild disability	1
	significant disability	2
managing money	no disability	0
	mild disability	1
	significant disability	2
meal preparations	no disability	0
	mild disability	1
	significant disability	2
shopping	no disability	0
	mild disability	1
	significant disability	2
telephoning	no disability	0
	mild disability	1
	significant disability	2
transportation	no disability	0
	mild disability	1
	significant disability	2

where:

• I modified the findings for functional health, since the terms used for the other measures seemed inappropriate.

subscore for physical health =

= SUM(points for all 9 measures)

subscore for cognitive health =

= SUM(points for all 6 measures)

subscore for functional health =

= SUM(points for all 9 measures)

Interpretation:

• minimum subscore: 0

• maximum physical health subscore: 20

• maximum cognitive health subscore: 12

• maximum functional health subscore: 18

• Recovery for a subscore was defined as >= 85% of baseline level.

• Full recovery was defined as recovery in all 3 subscores.

• Older patients had significant long-term disability.

NOTE: The authors described using ratios of the baseline and follow-up scores to determine the extent of recovery. In Table 1, this is described as the ratio of baseline to the follow-up score. On page 1407 it is described as the ratio of follow-up score to baseline. The following seems more reasonable to me:

percent recovery =

= ((maximal subscore) - (current subscore)) / ((maximal subscore) - (baseline score)) * 100%

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Description

Specialty

Objective

ICD-10

Recovery Assessment Following West Nile Virus Encephalitis

Purpose: To evaluate the recovery of a patient after West Nile Virus encephalitis using the outcome measures of Klee et al.

Description

Specialty

Objective

ICD-10