Friday, January 15, 2016

Clinical predictors in Guillain-Barré syndrome


From a recent study:

Methods

We retrospectively analyzed the clinical data of 541 patients who were diagnosed with GBS from 2003 to 2014. Independent predictors for MV and short-term prognosis in mechanically ventilated patients were identified via multivariate logistic regression analysis.

Results

The mean age was 41.6 years with a male predilection (61.2 %). Eighty patients (14.8 %) required MV. Multivariate analysis revealed that shorter interval from onset to admission (p less than 0.05), facial nerve palsy (p less than 0.01), glossopharyngeal and vagal nerve deficits (p less than 0.01) and lower Medical Research Council (MRC) sum score at nadir (p less than 0.01) were risk factors for MV; disease occurrence in summer (p less than 0.01) was a protective factor. As to prognostic factors, absence of antecedent infections (p less than 0.01) and lower MRC sum score at nadir (p less than 0.01) were predictors of poor short-term prognosis in mechanically ventilated patients regardless of treatment modality. We further investigated the predictors of poor short-term prognosis in patients requiring MV with different nadir MRC sum scores. Combined use of intravenous corticosteroids with intravenous immunoglobulin (odds ratio 10.200, 95 % confidence interval 1.068–97.407, p less than 0.05) was an independent predictor of poor short-term prognosis in mechanically ventilated patients with a nadir MRC sum score from 0 to 12 points, regardless of existence of antecedent infection.

Conclusions

Clinical predictors of MV and poor short-term prognosis in mechanically ventilated GBS patients were distinct. Add-on use of intravenous corticosteroids was a risk factor for poor short-term prognosis in mechanically ventilated patients with a nadir MRC sum score from 0 to 12 points.


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