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老年吉兰-巴雷综合征患者的预后因素:年龄有影响吗?

Prognostic Factors in Elderly Patients With Guillain-Barré Syndrome: Does Age Matter?

作者信息

Briseño-Godínez Maria Eugenia, Arauz Antonio, López-Hernández Juan Carlos, de Saráchaga Adib Jorge, Pérez-Valdez Esther Y, May-Más Raúl Nathanael, López-Hernández Gabriela, Bazán-Rodriguez Lisette, Galnares-Olalde Javier Andrés, León-Manríquez Elizabeth, Vargas-Cañas Edwin Steven

机构信息

Neuromuscular Department, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez," Mexico City, Mexico.

Geriatrics Department, Regional General Hospital 251, Instituto Mexicano del Seguro Social (IMSS), Metepec, Mexico.

出版信息

Neurohospitalist. 2021 Oct;11(4):303-309. doi: 10.1177/19418744211002676. Epub 2021 Mar 22.

Abstract

INTRODUCTION

Twenty to 40% of Guillain Barré syndrome (GBS) patients will not be able to walk independently despite effective treatment. Older patients carry additional risks for worse outcomes.

METHODS

A single center, ambispective cohort study was performed. Only subjects ≥18 years with a 3-month follow-up were included. Elderly patients were considered as a whole if ≥ 60 years. Demographics, CSF and nerve conduction studies were compared. A binomial logistic regression and Kaplan-Meier analyses were carried out to estimate good prognosis (Hugues ≤2) at 3-month follow-up.

RESULTS

From 130 patients recruited, 27.6% were elderly adults. They had a more severe disease, higher mEGOS and more cranial nerve involvement. Age ≥70 years, invasive mechanical ventilation and axonal subtype, portrayed an unfavorable 3-month outcome. Further analysis demonstrated an earlier recovery in independent walk at 3 months for patients <70 years.

CONCLUSIONS

Elderly patients with GBS have a more severe disease at admission and encounter worse prognosis at 3-month follow-up, especially those above 70 years.

摘要

引言

尽管接受了有效治疗,但20%至40%的吉兰-巴雷综合征(GBS)患者仍无法独立行走。老年患者出现更差预后的风险更高。

方法

开展了一项单中心、双向队列研究。仅纳入年龄≥18岁且随访3个月的受试者。年龄≥60岁的老年患者作为一个整体进行考量。对人口统计学、脑脊液和神经传导研究进行了比较。进行了二项逻辑回归和Kaplan-Meier分析,以评估3个月随访时的良好预后(休斯评分≤2)。

结果

在招募的130例患者中,27.6%为老年成年人。他们的病情更严重,改良埃姆斯沃思量表(mEGOS)评分更高,且更多累及颅神经。年龄≥70岁、有创机械通气和轴索性亚型预示着3个月时预后不佳。进一步分析表明,年龄<70岁的患者在3个月时独立行走恢复得更早。

结论

GBS老年患者入院时病情更严重,在3个月随访时预后更差,尤其是70岁以上的患者。

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