Dipartimento di Medicina di Urgenza Fondazione, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Dipartimento Universitario di Medicina Interna, Università Cattolica del Sacro Cuore, Rome, Italy.
Neurol Res. 2022 Nov;44(11):964-968. doi: 10.1080/01616412.2022.2075661. Epub 2022 May 17.
In Guillain-Barre syndrome (GBS), respiratory failure is the most serious manifestation and mechanical ventilation (MV) is required in approximately 20% of the patients. In this retrospective study, we aimed to evaluate clinical factors that can be evaluated in the Emergency Department which may influence the short-term prognosis of GBS patients.
Data were acquired regarding age, sex, antecedent infections, neurological signs and symptoms, cerebrospinal fluid examination, nerve conduction studies, treatment of GBS, need for MV, length of stay in the hospital, and discharge destination (home or rehabilitation). Charlson Comorbidity Index and modified Erasmus GBS outcome score (mEGOS) were collected on admission.
Seventy-eight GBS patients were recruited with a mean age of 53.9 (range 19-81). Sixty-nine (88.46%) were diagnosed with GBS and nine (11.54%) had classic Miller-Fisher syndrome. Mean values for the Charlson Comorbidity index were 1.20 ± 1.81, and the values of mEGOS were 2.4 ± 1.6. The rate of home discharge and rehabilitation was similar between elderly and younger patients. Patients who required MV had higher mEGOS (p-value=0.061). Regarding the electrophysiological subtypes, we did not observe a significant difference between AIDP and AMAN/AMSAN concerning the need for MV, the type of discharge, values of mEGOS and Charlson Comorbidity Index.
A significant correlation was found between mEGOS and the need for MV. Age did not influence the short-term prognosis of GBS patients. mEGOS may be a useful tool for predicting outcomes in patients with GBS and higher mEGOS scores on admission significantly correlated with poor outcomes.
在吉兰-巴雷综合征（GBS）中，呼吸衰竭是最严重的表现，约 20%的患者需要机械通气（MV）。在这项回顾性研究中，我们旨在评估急诊科可评估的临床因素，这些因素可能影响 GBS 患者的短期预后。
收集了年龄、性别、前驱感染、神经体征和症状、脑脊液检查、神经传导研究、GBS 治疗、MV 需要、住院时间和出院去向（家庭或康复）的数据。入院时收集 Charlson 合并症指数和改良 Erasmus GBS 结局评分（mEGOS）。
共纳入 78 例 GBS 患者，平均年龄为 53.9 岁（范围 19-81 岁）。69 例（88.46%）诊断为 GBS，9 例（11.54%）为经典 Miller-Fisher 综合征。Charlson 合并症指数的平均值为 1.20±1.81，mEGOS 的平均值为 2.4±1.6。需要 MV 的患者 mEGOS 较高（p 值=0.061）。关于电生理亚型，我们没有观察到 AIDP 和 AMAN/AMSAN 之间在 MV 需求、出院类型、mEGOS 和 Charlson 合并症指数方面有显著差异。
mEGOS 与 MV 需求之间存在显著相关性。年龄并不影响 GBS 患者的短期预后。mEGOS 可能是预测 GBS 患者结局的有用工具，入院时较高的 mEGOS 评分与不良结局显著相关。
