Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Peripher Nerv Syst. 2019 Jun;24(2):168-173. doi: 10.1111/jns.12320. Epub 2019 May 8.
Guillain-Barré syndrome (GBS) is an acute immune-mediated neuropathy that has variable disease course and outcome. The Erasmus GBS outcome score (EGOS), modified EGOS (mEGOS), and Erasmus GBS respiratory insufficiency score (EGRIS) are prognostic models designed to predict the functional outcome of GBS patients at 6 months (EGOS and mEGOS) and the need for mechanical ventilation within a week of admission (EGRIS). The models were primarily developed in the Dutch GBS population, and thus the usefulness of these models in other GBS cohorts is less clear. In the current study, we aimed to validate mEGOS, EGOS, and EGRIS in Malaysian GBS patients. A total of 107 patients with GBS and its variants were consecutively recruited. Patients with GBS and Miller Fisher syndrome (MFS) were analysed separately. In the GBS cohort, high mEGOS and EGOS scores were significantly correlated with poor outcome at 6 months (mEGOS on admission: r = .381, P = .005; mEGOS at day 7 of admission: r = .507, P < .001; EGOS: r = .484, P < .001). However, there were no significant correlations between mEGOS or EGOS and outcome in patients with MFS (mEGOS on admission: r = .152, P = .523; mEGOS at day 7 of admission: r = .008, P = .973; EGOS: r = .110; P = .644). The score of EGRIS for GBS patients with mechanical ventilation was significantly higher than those patients without mechanical ventilation (4 ± 2 vs 3 ± 1; P < .001). We conclude that mEGOS and EGOS are clinically useful and relevant to the Malaysian GBS population but not in patients with classic MFS. EGRIS could be used to predict the need for mechanical ventilation in our local GBS patients.
格林-巴利综合征（GBS）是一种急性免疫介导性神经病，其病程和结局存在差异。Erasmus GBS 结局评分（EGOS）、改良 EGOS（mEGOS）和 Erasmus GBS 呼吸衰竭评分（EGRIS）是用于预测 GBS 患者 6 个月时功能结局（EGOS 和 mEGOS）和入院后一周内需要机械通气（EGRIS）的预后模型。这些模型最初是在荷兰 GBS 人群中开发的，因此这些模型在其他 GBS 队列中的有效性尚不清楚。在本研究中，我们旨在验证 mEGOS、EGOS 和 EGRIS 在马来西亚 GBS 患者中的适用性。共连续招募了 107 例 GBS 及其变异型患者。对 GBS 和 Miller Fisher 综合征（MFS）患者分别进行了分析。在 GBS 队列中，较高的 mEGOS 和 EGOS 评分与 6 个月时的不良结局显著相关（入院时 mEGOS：r=.381，P=.005；入院后第 7 天 mEGOS：r=.507，P<.001；EGOS：r=.484，P<.001）。然而，在 MFS 患者中，mEGOS 或 EGOS 与结局之间没有显著相关性（入院时 mEGOS：r=.152，P=.523；入院后第 7 天 mEGOS：r=.008，P=.973；EGOS：r=.110，P=.644）。有机械通气的 GBS 患者的 EGRIS 评分显著高于无机械通气的患者（4±2 与 3±1；P<.001）。我们得出结论，mEGOS 和 EGOS 在马来西亚 GBS 人群中具有临床意义和相关性，但在经典 MFS 患者中则不然。EGRIS 可用于预测我们当地 GBS 患者机械通气的需求。
