Bayu Habtu Tsehayu, Demilie Atalay Eshetie, Molla Misganew Terefe, Kumie Fantahun Tarekegn, Endeshaw Amanuel Sisay
Department of Anesthesia, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
Front Neurol. 2024 Oct 30;15:1484661. doi: 10.3389/fneur.2024.1484661. eCollection 2024.
Guillain-Barré syndrome (GBS) is a rare autoimmune disease that affects the peripheral nervous system. It is characterized by the destruction of nerves involved in movement. This condition can lead to transient pain, changes in temperature and touch sensations, muscle weakness, loss of sensation in the legs and/or arms, and difficulty swallowing or breathing. Published data on the outcomes of critical care for patients with GBS are extremely scarce in Africa, particularly Ethiopia. Therefore, this study aimed to assess mortality and its predictors among patients with GBS in the intensive care unit (ICU) of specialized hospitals in Ethiopia, a low-income country.
This retrospective cohort study was conducted at the Tibebe Ghion Specialized Hospital and the Felege Hiwot Comprehensive Specialized Hospital in Bahir Dar, Ethiopia, from 1 January 2019 to 30 December 2023. Data were collected in the medical record rooms. Cox regression analysis was performed to identify the predictors of mortality among GBS patients in the ICU. The crude and adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs) were calculated using bivariable and multivariable Cox regression models. A -value of <0.05 was considered statistically significant.
Of 124 GBS patients admitted to the ICU, 120 were included in the final analysis. During the follow-up, there were 23 (19.17%) deaths. The overall incidence rate of death was 1.96 (95% CI: 1.30, 2.95) per 100 person-days of observation. Traditional medicine (AHR = 3.11, 95%: 1.12, 16.70), COVID-19 infection (AHR = 5.44, 95% CI: 1.45, 73.33), pre-ICU cardiac arrest (AHR = 6.44, 95% CI: 2.04, 84.50), and ICU readmission (AHR = 4.24, 95% CI: 1.03, 69.84) were identified as the independent predictors of mortality.
The mortality rate among GBS patients admitted to the ICU was high. Traditional medicine, COVID-19 infection, pre-ICU cardiac arrest, and readmission to the ICU were the significant predictors of mortality. Conducting large-scale studies with a prospective design in the future would yield more robust evidence.
吉兰 - 巴雷综合征（GBS）是一种罕见的自身免疫性疾病，会影响周围神经系统。其特征是参与运动的神经遭到破坏。这种病症可导致短暂性疼痛、温度和触觉变化、肌肉无力、腿部和/或手臂感觉丧失以及吞咽或呼吸困难。在非洲，尤其是埃塞俄比亚，关于GBS患者重症监护结果的已发表数据极为稀少。因此，本研究旨在评估埃塞俄比亚这个低收入国家专科医院重症监护病房（ICU）中GBS患者的死亡率及其预测因素。
这项回顾性队列研究于2019年1月1日至2023年12月31日在埃塞俄比亚巴赫达尔的提贝贝·吉翁专科医院和费莱格·希沃特综合专科医院进行。数据在病历室收集。进行Cox回归分析以确定ICU中GBS患者死亡率的预测因素。使用双变量和多变量Cox回归模型计算粗风险比和调整后风险比（AHRs）以及95%置信区间（CIs）。P值<0.05被认为具有统计学意义。
在入住ICU的124例GBS患者中，120例纳入最终分析。随访期间，有23例（19.17%）死亡。总体死亡发生率为每100人日观察期1.96（95%CI：1.30，2.95）。传统医学治疗（AHR = 3.11，95%：1.12，16.70）、新冠病毒感染（AHR = 5.44，95%CI：1.45，73.33）、入住ICU前心脏骤停（AHR = 6.44，95%CI：2.04，84.50）以及再次入住ICU（AHR = 4.24，95%CI：1.03，69.84）被确定为死亡率的独立预测因素。
入住ICU的GBS患者死亡率较高。传统医学治疗、新冠病毒感染、入住ICU前心脏骤停以及再次入住ICU是死亡率的重要预测因素。未来开展前瞻性设计的大规模研究将产生更有力的证据。
