BACKGROUND AND OBJECTIVES: To identify factors predictive of a favourable modified Rankin score (mRS) at 12 months in patients with autoimmune encephalitis (AE). To evaluate predictors of a binary composite clinical-functional outcome measure, encompassing mRS, drug-resistant epilepsy (DRE) and memory impairment, at 12 months. METHODS: Univariable and multivariable logistic regression analyses for predictors of a favourable mRS (i.e. mRS ≤ 2) and a composite clinical-functional outcome at 12 months were used. RESULTS: A total of 231 patients with AE were recruited. Multivariable logistic regression identified factors predictive of reduced odds of favourable mRS at 12 months were older age (OR 0.97
95% CI 0.95, 0.98
p <
0.002), T2/FLAIR hyperintensity on initial MRI (OR 0.27
95% CI 0.13, 0.56
p <
0.002), RSE (OR 0.17
95% CI 0.06, 0.52
p = 0.002) and first-line immunotherapy failure (OR 0.18
95% CI 0.09, 0.37
p <
0.002). Anti-LGI1 antibody-mediated encephalitis relative to other subtypes (OR 4.46
95% CI 1.55, 12.80
p = 0.006) was associated with a better 12-month mRS. We found concordant associations for a composite outcome at 12 months, with the addition of a diagnosis of definite autoimmune limbic encephalitis (AILE) predicting a poor outcome. DISCUSSION: Older age, MRI T2/FLAIR hyperintensity, RSE and first-line immunotherapy failure predicted worse mRS and composite clinical-functional outcome at 12 months, while a diagnosis of anti-LGI1 antibody-mediated encephalitis was associated with favourable outcomes. Our data highlight acute clinical factors predictive of a more severe clinical and functional course at 12 months.