Risk factors for the severity of Guillain-Barré syndrome and predictors of short-term prognosis of severe Guillain-Barré syndrome

AbstractGuillain-Barré syndrome (GBS) is a neurological disorder characterized by paralysis. Identifying the severity, appropriate therapeutic method, and prognosis of GBS at an early stage is highly important. This study aimed to investigate the modifiable risk factors for the severity of GBS and consequent need for mechanical ventilation (MV) and to identify clinical predictive factors for poor short-term outcomes of severe GBS. 155 GBS patients who were admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University during 2014–2020 were enrolled. Demographic, clinical, therapeutic and evolutionary data were collected and were then analyzed using univariate and multivariate regression analyses. Our analytic data demonstrated that the significant clinical predictors of severe GBS were recent history of surgery, older age, cranial nerve impairment, and elevated levels of liver enzymes (p < 0.05). Furthermore, autonomic dysfunction, lower Medical Research Council (MRC) score at nadir, and elevated levels of liver enzymes were significantly associated with MV for severe GBS (p < 0.05), and lower MRC score at nadir and autonomic dysfunction remained significant predictors of MV in severe GBS (p < 0.05). Lastly, recent history of surgery, lower MRC score at admission and at nadir, requirement for MV, and pneumonia during hospitalization were significantly associated with the short-term outcome of severe GBS and that lower MRC score at admission and need for MV were confirmed to be predictors of poor short-term prognosis (p < 0.05). Of note, this study suggested that recent history of surgery is a predictor of severity in GBS patients and is associated with the poor short-term prognosis of severe GBS.

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Guillain-Barré syndrome in patients with a recent history of Zika in Cúcuta, Colombia: A descriptive case series of 19 patients from December 2015 to March 2016

Journal of Critical Care ◽

10.1016/j.jcrc.2016.08.016 ◽

2017 ◽

Vol 37 ◽

pp. 19-23 ◽

Cited By ~ 50

Author(s):

Arturo Arias ◽

Lilian Torres-Tobar ◽

Gualberto Hernández ◽

Deyanira Paipilla ◽

Eduardo Palacios ◽

...

Keyword(s):

Case Series ◽

Guillain Barre Syndrome ◽

Recent History ◽

Guillain Barré Syndrome ◽

History Of ◽

Guillain Barré

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Predictors and Risk Factors of Severity of GBS, the Requirement for Mechanical Ventilation and Poor Short-Term Prognosis of Severe GBS

10.21203/rs.3.rs-59999/v1 ◽

2020 ◽

Author(s):

Pu-Yuan Wen ◽

Min Zhang ◽

Wen-Zheng Chu ◽

Qiao-Chan Feng ◽

Han Ji ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Autonomic Dysfunction ◽

Cranial Nerve ◽

Recent History ◽

History Of Surgery ◽

Logistic Analysis ◽

Severity Scores ◽

Short Run ◽

History Of

Abstract Background/Objective:It is still an extraordiarily exigent thing to early recognize the severity, therapeutic method and prognisis of Guillain-Barré syndrome (GBS). Our research’s goal is to investigate the clinical predictive factors indicating severity of GBS and the requirement for mechanical ventilation(MV) in severe patients with GBS, and to explore the identification of modifiable risk factors for predicting poor short-run outcome of severe GBS. Methods: A total of 155 patients were included in a cohort of GBS patients admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University between 2014 and 2020. Demographic, clinical, therapeutical and evolutionary data were collected. Neurological testing which used standardized data collection were carried out by the same investigators on the whole study period. Comparion of the results were implemented by single and multiple regression analysis.Result: Of 155 patients, 66 patients were severe GBS, of which twenty-nine patients (18.7%) needed MV. Significant clinical predictors for severe GBS were recent history of surgery, time from onset to admission, Medical Research Council(MRC) sum score on admission, autonomic dysfunction, cranial nerve impairment(glossopharyngeal, facial, Oculomotor and/or abducent nerve deficits) and elevated liver enzyme levels were significantly bound up with severity scores(p<0.05). With regard to risk factors of MV in severe GBS, univariate logistic analysis indicated presence of cranial nerve involvement, autonomic dysfunction, MRC score at nadir, elevated liver enzymes and pneumonia were significantly different(p<0.05); Multivariate analysis determined that MRC score at nadir and autonomic dysfunction were also considered to be predictors for MV in severe GBS(p<0.05).As to prognostic of factors, recent history of surgery, MRC score at nadir, the requirement for MV, MRC score at admission and pneumonia during hospitalization were predictors of poor short-run outcome in severe patients with GBS by univariate logistic analysis, and that the nadir MRC score and the requirement for MV were identically proved as clinic parameters of unfavourable prognosis by multivariate logistic analysis (p<0.05) .Conclusions: Clinical risk factors of severity in GBS, the requirement of MV and unfavourable short-run prognosis in severe GBS were evident. Recent history of surgery is also a predictor for severity in GBS patients.

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Safe Administration of Ipilimumab, Pembrolizumab, and Nivolumab in a Patient with Metastatic Melanoma, Psoriasis, and a Previous Guillain–Barré Syndrome

Case Reports in Oncological Medicine ◽

10.1155/2018/2783917 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Alessio Cortellini ◽

Alessandro Parisi ◽

Maria Concetta Fargnoli ◽

Katia Cannita ◽

Azzurra Irelli ◽

...

Keyword(s):

Risk Factors ◽

Case Report ◽

Metastatic Melanoma ◽

Checkpoint Inhibitors ◽

Guillain Barre Syndrome ◽

Immune Disorders ◽

Guillain Barré Syndrome ◽

History Of ◽

Sequential Treatments ◽

Guillain Barré

Background. Patients with autoimmune diseases were not evaluated in clinical trials with immune checkpoint inhibitors (ICIs), since a history of immune disorders, such as Guillain–Barré syndrome (GBS) and psoriasis, is one of the major risk factors for the development of immune-related adverse events (irAEs). This risk cannot be defined; therefore, physicians are called to manage these patients in clinical practice. Case Report. We report the case of a 62-year-old male patient affected by metastatic melanoma, with a history of GBS and psoriasis, and treated with sequential ipilimumab, pembrolizumab, and nivolumab, without significant toxicities. Conclusion. This case report supports that although a history of immune disorders is one of the major risk factors for development of irAEs, in some patients, it could be possible to safely administer sequential treatments with ICIs. A proper decision should be made, considering therapeutic options, disease-related risks, and those related to a recurrence of preexisting autoimmune disorders.

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