Factors associated with long-term functional outcomes and psychological sequelae in Guillain–Barre syndrome

Khan, Farees; Pallant, Julie; Ng, Louisa; Bhasker, A.

doi:10.1007/s00415-010-5653-x

Cited by 52 publications

(46 citation statements)

References 33 publications

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“…In a similar study [12] among 70 patients examined 3-5 years after GBS, 27% reported changes in personal life style because of increased fatigability. Dornonville et al [3] and Khan et al [13] evaluated patients a mean of 6 years following the acute disease (range 1-14 years). In spite of good recovery of objective measures of motor skills, the quality of life of the patients showed prominent impairment as compared with healthy individuals in items related to capabilities at workplace and maintenance of social relationships, as well as in self-confidence and ability to live independently.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of fatigue over 20 years after recovery from Guillain–Barré syndrome

Drory

Bronipolsky

Bluvshtein

et al. 2012

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 99%

Occurrence of fatigue over 20 years after recovery from Guillain–Barré syndrome

Drory

Bronipolsky

Bluvshtein

et al. 2012

Journal of the Neurological Sciences

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“…Other studies report similar prevalence (27.7%) of urinary dysfunction in pwGBS, including urinary retention (9.2%) 13. In a study of factors impacting longer-term health-related outcomes in pwGBS ( n =76), 17% reported ongoing bladder dysfunction (urgency, frequency or nocturia) 11. Few studies however, report on the mechanism of bladder dysfunction and/or urodynamic data in this population 13.…”

Section: Introductionmentioning

confidence: 86%

“…The distal motor weakness, autonomic disturbances and psychological issues are the key features of GBS. Although majority of GBS survivors (75%) have good motor outcomes (i.e., ability to walk independently),7 the impact of GBS on activities of daily living, work, social activities and health-related quality of life (QoL) is considerable at 2-6 years after onset and persists beyond this time 8-11…”

Section: Introductionmentioning

confidence: 99%

“…The pwGBS discharged into the community continue to improve over many months, but may have issues including urinary problems in the transition period, that may limit activity and restrict participation. Various studies suggest longer-term supportive care for pwGBS in the community 2,11,16. The existing studies12,13,17-21 however, report urinary dysfunction in acute phase of GBS only, while those in the chronic phase in the community have not been studied.…”

Section: Introductionmentioning

confidence: 99%

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Guillain-Barré Syndrome: Prevalence and Long-Term Factors Impacting Bladder Function in an Australian Community Cohort

et al. 2013

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Background and PurposeUrinary dysfunction is associated with significant morbidity in persons with Guillain-Barré Syndrome (GBS). The aim of this study was to describe prevalence and long-term impact of bladder dysfunction on daily activities and quality of life (QoL) in persons in chronic phase of GBS and to examine the relationships between commonly used continence measures in this cohort.MethodsProspective cohort (n=66) following GBS treatment (1996-2009) was recruited from a tertiary hospital and assessed using standardised measures for bladder dysfunction: American Urological Association (AUA) Symptom Index, Incontinence Impact Questionnaire, Urogenital Distress Inventory.ResultsSixty-six participants (64% male, mean age 56 years, median disease duration of 6.1 years) completed the study. Of these more than half reported nocturia and one-third reported urinary urgency and frequency. Urinary problems impacted on participants' daily activities: physical recreation (21%), emotional health and mood (17%), entertainment (14%), participation and mobility (>30 min) (12%), and performance of household chores (8%). Since GBS, 49% reported interference of urinary symptoms with daily life to some extent; and adverse impact on QoL (10.6%). Significant relationship between bladder symptoms; and the level of urogenital distress (p<0.001) and the impact of urinary problems (p<0.001), was noted. Higher scores on the bladder scales showed significant correlations with psychological, functional and participation scales. The single QoL item (AUA scale) correlated significantly with all other bladder scales (rho=0.63-0.86). This can be a potential 'screening tool' to identify patients for further assessment.ConclusionsBladder dysfunction in chronic phase of GBS is not well studied. More research in longer-term screening and outcomes for bladder intervention are needed for integrated care and to guide treating clinicians.

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“…Motor deprivation and loss of communication were the most important causes of anxiety. Khan et al 29 reported that depression, anxiety and stress are observed in about 20% of GBS patients a median 6 years after their discharge from neuro-ICU. Therefore, these two studies have assessed anxiety during the stay and after discharge from the ICU, respectively, whereas the present study has focused on anxiety at admission.…”

Section: Discussionmentioning

confidence: 99%

Relevance of anxiety in clinical practice of Guillain-Barré syndrome: a cohort study

et al. 2012

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ObjectivesIllness is often associated with anxiety, but few data exist about the prognostic significance of this phenomenon. To address this issue, we assessed whether patient anxiety is associated with subsequent need for intubation in Guillain-Barré syndrome (GBS).DesignIncident case-cohort study.SettingAcute secondary care in a teaching hospital (France) from 2006 to 2010.Participants110 adult GBS patients. Either language barrier or cognitive decline that precluded understanding was considered as exclusion criteria.Primary outcomeAcute respiratory failure.InterventionsAt admission, anxiety and clinical factors (including known predictors of respiratory failure: delay between GBS onset and admission, inability to lift head, vital capacity (VC)) were assessed and related to subsequent need for mechanical ventilation (MV). Anxiety was assessed using a Visual Analogical Scale (VAS), the State Anxiety Inventory form Y1 (STAI-Y1) score and a novel-specific questionnaire, evaluating fears potentially triggered by GBS. Patients were asked to choose which they found most stressful from weakness, pain, breathlessness and uncertainty.Results23 (22%) were subsequently ventilated. Mean STAI-Y1 was 47.2 (range 22–77) and anxiety VAS 5.2 (range 0–10). STAI was above 60/80 in 22 (21%) patients and anxiety VAS above 7/10 in 28 (27%) patients. Fear of remaining paralysed, uncertainty as to how the disease would progress and fear of intubation were the most stressful. Factors significantly associated with anxiety were weakness and bulbar dysfunction. STAI-Y1 was higher and uncertainty more frequent in subsequently ventilated patients, who had shorter onset-admission delay and greater weakness but not a lower VC. Uncertainty was independently associated with subsequent MV.ConclusionsEarly management of patients with GBS should evaluate anxiety and assess its causes both to adjust psychological support and to anticipate subsequent deterioration.

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Factors associated with long-term functional outcomes and psychological sequelae in Guillain–Barre syndrome

Abstract: GBS is complex and requires long-term management of psychological sequelae impacting activity and participation.

Cited by 52 publications

References 33 publications

Occurrence of fatigue over 20 years after recovery from Guillain–Barré syndrome

Occurrence of fatigue over 20 years after recovery from Guillain–Barré syndrome

Guillain-Barré Syndrome: Prevalence and Long-Term Factors Impacting Bladder Function in an Australian Community Cohort

Relevance of anxiety in clinical practice of Guillain-Barré syndrome: a cohort study

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