Clinical predictors for mechanical ventilation and prognosis in patients with Guillian-Barre syndrome: a 10-year experience.

INTRODUCTION

Guillain-Barré syndrome (GBS) is a common cause of flaccid paralysis. Up to a third of cases result in respiratory failure requiring mechanical ventilation.

AIM: We aim to study the possible predictors of respiratory compromise requiring mechanical ventilation in cases of GBS as well as their clinical outcome in the UAE population.

METHODOLOGY: A retrospective observational study was conducted between the periods of January 2009 till January 2019 in a tertiary center in Dubai. Cases were grouped according to their need for mechanical ventilation then compared for possible predicting factors. Up to 1-year follow-up was done to assess the clinical outcome.

RESULTS

Out of the 82 cases that were included in the study, 64 (78%) were males with a mean age at presentation being 37 ± 14.4. Most of the cases presented with disability score of 4 (n= 33, 40.2%), being bed bound or wheelchair bound. Twenty cases (24.4%) required mechanical ventilation at presentation. Axonal type of nerve injury was present in 11 (55%) patients requiring intubation, in contrast to 17 (27.4%) patients not requiring intubation. Cases that required mechanical ventilation were older (P .028). They also had a reduced rate of recovery after 1 month (P .004), and more residual deficit at 6 months (P .003) and 12 months (P <.001). This also translated in a longer duration of hospital stay (<.001).

CONCLUSION

Older age at presentation is a major predictor for the need of mechanical ventilation in GBS. This need for mechanical ventilation is associated with longer hospital stay as well as reduced rate of recovery up to 1 year after the onset of presentation.