Highlights
- •Outcomes of GBS in Pakistan are comparable to other Asian countries.
- •Frequency of poor outcomes in mechanically ventilated patients was higher compared to regional data.
- •Referral bias and hospital level practices can contribute to this observation.
- •Increasing age, areflexia and longer LOS may predict poor outcome in MV patients.
Abstract
Outcomes of Guillain Barre Syndrome (GBS), particularly those require mechanical ventilation
have been reported from a number of Asian countries, albeit, scarcely from Pakistan.
We conducted this study to determine the short-term outcomes of GBS and compare the
results of mechanically ventilated and non-ventilated patients. Case records of patients
admitted with GBS during 2011–2016 at a large tertiary care centre of Pakistan were
retrospectively reviewed. 216 patients satisfying inclusion criteria were included.
Patients were divided into 2 groups based on requirement of MV (MV and non-MV group).
Short term outcomes were assessed by Modified Rankin Scale (MRS) at discharge, 2 weeks
and 3 months and comparison done between MV and non-MV group. Outcome based on MRS
score is categorized as good (MRS = 0–3) or poor (MRS = 4–6). Requirement for MV was
noted in 24.5%. MV patients had severe weakness at presentation, longer length of
hospital stay (LOS) and higher frequency of in-hospital complications. Overall mortality
was 7.9%. Good outcomes at discharge and at 3 months were noted in significantly higher
frequency in non-MV group (50.3% and 93.2% respectively) as compared to MV group (11.3%
and 33.3% respectively). In MV group, increasing age, areflexia and longer LOS stay
were found as independent predictors of poor outcome. Overall outcomes of GBS in our
population are comparable to both regional and international studies. However, poor
outcomes in MV group are seen in higher frequency in our study. Increasing age, areflexia
and longer LOS may predict poor outcome in MV patients.
Keywords
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Article info
Publication history
Published online: November 23, 2018
Accepted:
November 11,
2018
Received:
September 26,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
