Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh.
Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Ann Clin Transl Neurol. 2022 Aug;9(8):1264-1275. doi: 10.1002/acn3.51627. Epub 2022 Jul 30.
We have assessed and improved the performance of the modified Erasmus GBS Outcome Score (mEGOS) among patients with Guillain-Barré syndrome (GBS) from Bangladesh.
Validation cohort consisted of patients with GBS from two prospective cohort studies in Bangladesh. Poor outcome was defined as being unable to walk independently at week 4 and week 26. We excluded patients able to walk independently, patients who died within the first week, or with missing GBS disability scores. Performance of mEGOS at entry and week 1 was determined based on the discriminative ability (ability to differentiate between patients able and unable to walk independently; measured using the area under the receiver operating characteristic curves [AUC]) and calibration (observed probability versus predicted probability of poor outcome).
A total of 506 patients aged ≥6-year-old were enrolled, with 471 and 366 patients included in mEGOS validation analysis at entry and week 1, respectively. The AUC values for predicting poor outcome (1) at week 4 were 0.69 (mEGOS entry) and 0.78 (mEGOS week 1) and (2) at week 26 were 0.67 (mEGOS entry) and 0.70 (mEGOS week 1). Mean predicted probabilities of poor outcome corresponded with observed outcomes except for the probability of poor outcome at week 4 which was overestimated by mEGOS week 1. This was resolved by updating the model intercept.
The mEGOS shows valid outcome predictions among patients with GBS from Bangladesh. The model can aid the identification of patients at high risk of poor outcome and help to adequately allocate healthcare resources in low-resource settings.
我们评估并改进了孟加拉国吉兰-巴雷综合征（GBS）患者改良的 Erasmus GBS 结局评分（mEGOS）的性能。
验证队列包括来自孟加拉国两项前瞻性队列研究的 GBS 患者。不良结局定义为在第 4 周和第 26 周不能独立行走。我们排除了能够独立行走、在第一周内死亡或缺乏 GBS 残疾评分的患者。mEGOS 在进入和第 1 周的性能基于判别能力（区分能够和不能独立行走的患者的能力；使用接受者操作特征曲线下面积 [AUC] 测量）和校准（不良结局的观察概率与预测概率）。
共纳入 506 例年龄≥6 岁的患者，其中 471 例和 366 例分别纳入 mEGOS 进入和第 1 周的验证分析。预测不良结局（1）在第 4 周的 AUC 值为 0.69（mEGOS 进入）和 0.78（mEGOS 第 1 周），（2）在第 26 周的 AUC 值为 0.67（mEGOS 进入）和 0.70（mEGOS 第 1 周）。不良结局的平均预测概率与观察结果相符，除了第 4 周的不良结局概率被 mEGOS 第 1 周高估外。通过更新模型截距解决了这个问题。
mEGOS 对孟加拉国 GBS 患者的预后预测具有有效性。该模型有助于识别预后不良风险较高的患者，并有助于在资源匮乏的环境中合理分配医疗资源。
