Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020

Zhai, Qiongqiong; Guo, Cheng; Xue, Fu‐Shan; Qiang, Jun; Li, Chaonan; Guo, Li

doi:10.3390/jcm11216323

Cited by 3 publications

(6 citation statements)

References 41 publications

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“…Bulbar dysfunction predicted respiratory failure in several studies [4–10, 15–18, 20, 23–27, 33, 36]. Our study confirms bulbar and neck weakness as significant predictors of MV.…”

Section: Discussionsupporting

confidence: 82%

“…Guillain−Barré syndrome (GBS) is a rapidly progressive, auto-immune polyradiculoneuropathy [1][2][3][4][5][6][7]. During the acute phase, patients may develop respiratory failure, eventually requiring mechanical ventilation (MV) [2,[4][5][6][7][8][9][10][11][12][13][14]. Early prediction of respiratory insufficiency is important to correctly triage the patients for appropriate level of care and to prevent complications related to delayed intubation [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of respiratory failure in Guillain−Barré syndrome: a 22 year cohort study from a single Italian centre

Galassi,

Mazzoli,

Ariatti

et al. 2023

Euro J of Neurology

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Background and purposeThe study aimed to identify predictors of respiratory failure leading to mechanical ventilation (MV) and tracheostomy in Guillain−Barré syndrome (GBS).MethodsTwo hundred and thirty adult cases admitted to the Neurology Unit of Modena, Italy, between January 2000 and December 2021 were studied. A cut‐off of MV starting within 8 weeks from onset of weakness was used. Univariable, multivariable logistic and Cox regression analyses were used to determine which pre‐specified clinical and diagnostic characteristics were capable of predicting MV and tracheostomy, due to weaning failure. The model was internally validated within the full cohort. The Erasmus GBS Respiratory Insufficiency Score was retrospectively applied.ResultsOne hundred and seventy‐six cases (76.5%) were classified as classical sensorimotor GBS and 54 (23.4%) as variants. Thirty‐two patients (13.9%) needed MV: 84.3% required respiratory support within 7 days. Independent predictors of respiratory failure and MV were older age, facial, bulbar, neck flexor weakness, dysautonomia, axonal electrophysiological subtype, cardiovascular comorbidities and higher disability score at entry. There was no association with abnormal spinal fluid parameters nor with positive serology for recent infections. Twenty‐two patients (68.7%) were ventilated for more than 7 days; 4.7% died within 8 weeks. The patients who required MV were treated more often with plasma exchange. Independent predictors of tracheostomy due to weaning trial failure were facial, bulbar, neck flexor weakness, autonomic dysfunction, associated cardiovascular morbidities and axonal electrophysiological subtype on nerve conduction study.ConclusionsOur study indicates distinct predictors of MV and tracheostomy in GBS patients.

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“…Bulbar dysfunction predicted respiratory failure in several studies [4–10, 15–18, 20, 23–27, 33, 36]. Our study confirms bulbar and neck weakness as significant predictors of MV.…”

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Predictors of respiratory failure in Guillain−Barré syndrome: a 22 year cohort study from a single Italian centre

Galassi,

Mazzoli,

Ariatti

et al. 2023

Euro J of Neurology

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“…Netto and colleagues found that older age, dysautonomia, and pulmonary complications were predictors of mortality in MV patients with GBS [40]. Zhai and their colleague [11] found that HDS (at admission), dysphagia, and dysautonomia were independent risk factors for GBS patients requiring MV. Hyponatremia occurred in 19 (30.6%) patients and was significantly correlated with HDS and ONLS outcomes (p = 0.002, p = 0.001, respectively) and was considered as a predictor of poor prognosis, consistent with previous studies [41][42][43].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies found a relationship between outcome and recent preceding infections (antecedent events), clinical presentation, electrophysiological subtype and laboratory findings [6][7][8][9]. Yao and colleagues studied the clinical presentation of GBS in four regions of China and found that a higher proportion of the axonal subtype in central and southwest China; progression in the latter region was more served at nadir and patients had the longest hospital stay [10] Zhai and their colleagues [11] in their retrospective study of 294 patients with GBS found that the AMAN subtype was predominant in northern China (40.1%) and had shorter time to nadir, with prolonged hospitalization, and worse prognosis at discharge than AIDP. A higher GDS score on admission was a strong predictor for poor outcome at discharge and short-term follow-up, independent of treatment type or in-hospital management (Ruiz-Sandoval and their colleagues) [12].…”

Section: Introductionmentioning

confidence: 99%

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The early clinical and laboratory predictors of GBS outcome: hospital-based study, Assiut University, Upper Egypt

Khedr

Mohamed

Shehab

2023

Egypt J Neurol Psychiatry Neurosurg

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Background This study was designed to identify factors that influence outcomes in a large group of well-defined Guillain–Barré syndrome (GBS) patients with a 3-month follow-up period. Sixty-two cases of GBS with a mean age of 37.15 ± 17.60 years (33 males and 29 females) were recruited in the first 2 weeks after onset. Clinical history, examination, and a variety of rating scales including Medial Research Council sum score (MRC), Erasmus Guillain-Barré respiratory insufficiency score (EGRIS), at admission and 10 days later were performed. Follow-up investigations at 3 months included the Hughes Disability Scale (HDS), and Overall Neuropathy Limitation Scale (ONLS). Results 64.5% of participants had cranial nerve deficits, 45% had neck muscle weakness, 30.6% had dysautonomia, and 8.1% were mechanically ventilated. C-reactive protein was elevated in 38.7%, and hyponatremia was recorded in 30.6% of patients. Older age, antecedent events particularly diarrhea, neck muscles weakness, low MRC sum score, impaired cough reflex, dysautonomia, and hyponatremia, were all significantly associated with poor outcomes at 3 months using HDS and ONLS. Regression analysis with dependent variables of HDS outcome showed that the presence of an antecedent event particularly diarrhea, neck muscle weakness, hyponatremia and the presence cytoalbuminous dissociation of CSF at onset, and low MRC sum score at 10th day after treatment, were predictors of poor outcome. Conclusion Clinical and laboratory predictors of poor outcome were older age, the presence of an antecedent event particularly diarrhea, low MRC sum score at the 10th day, elevated CRP, hyponatremia and the presence cytoalbuminous dissociation.

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Clinical Characteristics of Guillain‐Barré syndrome in Shenzhen: A Retrospective Study

GUO,

YAO,

et al. 2024

Preprint

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Background Guillain-Barré syndrome (GBS) is a group of immune-mediated peripheral neuropathy that causes acute flaccid paralysis. The global incidence of GBS was 0.6-4/100 000, and the incidence in China was 0.698/100 000. Although the diagnosis and treatment of GBS has made rapid progress, approximately 20% of patients with GBS are still unable to walk alone within 6 months after the onset of GBS, and 40% of patients have sequelae, such as weakened strength, limb pain, and numbness, seriously affecting their life and work. We aimed to retrospectively analyze the clinical characteristics of patients with GBS in Shenzhen, China and analyze the factors affecting disease severity to provide a reference for the precise treatment of GBS. Methods Clinical data of inpatients diagnosed with GBS in several hospitals in Shenzhen from April 2010 to October 2021 were obtained from an electronic medical record system (HIS system). The clinical characteristics of patients with GBS and the factors affecting disease severity were analyzed. Results A total of 146 patients were identified for this study, and 13 were lost during follow-up. During the follow-up period, three patients had acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP). One hundred and thirty patients with complete data, comprising 90 males (69.23%) and 40 females (30.77%), with a median age of 39.50 ± 23.75 years, were included in the statistical analyses. Acute inflammatory demyelinating polyneuropathy (AIDP) was the most common clinical variant (106 cases [81.54%]). Miller-Fisher syndrome (MFS), acute motor axonal neuropathy (AMAN), and acute motor-sensory axonal neuropathy (AMSAN) were noted in 21 (16.15%), 2 (1.54%), and 1 (0.77%) patients, respectively. The clinical course of the disease was mainly mild in 95 cases (73.08%), while 35 patients (26.92%) experienced severe disease. Logistic multivariate regression analysis showed that being ≥ 60 years old and having a pulmonary infection might be related to the severity of the disease. Conclusions AIDP is the most common manifestation of GBS in Shenzhen. Most cases of GBS in our setting are mild, and the long-term prognosis is favorable. Old age (≥ 60 years) and having a pulmonary infection are independent risk factors for severe GBS.

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Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020

Cited by 3 publications

References 41 publications

Predictors of respiratory failure in Guillain−Barré syndrome: a 22 year cohort study from a single Italian centre

Predictors of respiratory failure in Guillain−Barré syndrome: a 22 year cohort study from a single Italian centre

The early clinical and laboratory predictors of GBS outcome: hospital-based study, Assiut University, Upper Egypt

Clinical Characteristics of Guillain‐Barré syndrome in Shenzhen: A Retrospective Study

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