Clinical Course and Predictors of Poor Functional Outcome in Guillain-Barré Syndrome. A Retrospective Study

Abstract

Introduction: Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis. It carries great morbidity due to an overall high rate of poor functional outcome. This study is conducted to study the predictors of poor functional outcome. Methods: This study a retrospective observational study, which was conducted in Rashid Hospital Tertiary Center in Dubai between 2009 and 2019. Functional status was assessed and followed by the GBS disability score. Functional outcome at 6 months was evaluated for possible predicting factors as well as associated outcomes. Results: Out of the 82 cases, the mean age at presentation is 37 ± 14.4, with 64 (78%) males. Around one-third of cases (37.8%) had residual deficits at 6 months. Follow-up after 6 months showed that cases with a poor functional outcome are older (p = 0.035) and have presented with a high disability score (p < 0.001) and a higher need for mechanical ventilation (p < 0.001). Axonal type of nerve injury resulted in poor functional outcome at 6 months compared to the demyelinating type of nerve injury (p = 0.034). Lower rate of improvement at 1 month and poor functional outcome at 6 months resulted in a longer hospital stay (p < 0.001). Conclusion: A poor functional status at presentation, axonal type of nerve injury, and the early requirement for mechanical ventilation are found to predict poor functional improvement after 6 months from diagnosis. These factors must be kept in consideration to facilitate more vigilant management of patient's associated high morbidity.