Long-Term Outcome of Guillain-Barré Syndrome

Koeppen, Susanne; Kraywinkel, Klaus; Wessendorf, Thomas; Ehrenfeld, Christiane E.; Schürks, Markus; Diener, H.-C.; Weimar, Christian

doi:10.1385/ncc:5:3:235

Cited by 40 publications

(25 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The GBS survivors made good functional recovery (median motor FIM score = 90) consistent with other studies [16,[22][23][24][25]. Participants reported residual neurological deficits (motor and sensory) [9,16,26] and minimal change in their physical status in relation to time elapsed since GBS. This is similar to other reports [17,25] that suggest that, at 2-3 years after GBS, there is no substantial expectation of recovery.…”

Section: Discussionsupporting

confidence: 85%

“…Severe ( [16,22,26], those treated in intensive care with severe GBS showed greater impact on QoL, and those with longer acute hospital stay ([11 days) recorded lower function and higher impact scores [22]. No association was found between the MRC Motor Scale Rating scores (at admission to acute hospital), nor time since GBS diagnosis (B6 vs. [6 years).…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Factors associated with long-term functional outcomes and psychological sequelae in Guillain–Barre syndrome

Khan

Pallant

et al. 2010

J Neurol

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 92%

Factors associated with long-term functional outcomes and psychological sequelae in Guillain–Barre syndrome

Khan

Pallant

et al. 2010

J Neurol

View full text Add to dashboard Cite

show abstract

“…[1] The factors which have been found to have an impact on mortality have been age,[35] specific antecedent events[5] rapidity of progression,[6] sensory disturbances, ventilatory requirement,[7] bulbar dysfunction,[8] dysautonomia,[3910] sepsis and pulmonary complications. [310] However, many of these predictors of mortality in literature have included the general cohort of GBS patients, or a small subgroup of mechanically ventilated patients. Few studies have been published from single academic institutions with detailed analysis of the circumstances relating to death and the prognostic factors for the same in a large cohort of mechanically ventilated patients of GBS.…”

Section: Introductionmentioning

confidence: 99%

Mortality in mechanically ventilated patients of Guillain Barré Syndrome

Netto

Taly

Kulkarni

et al. 2011

Ann Indian Acad Neurol

View full text Add to dashboard Cite

Background:The mortality of patients with Guillain Barré syndrome (GBS) has varied widely with rates between 1-18%. Death results from pneumonia, sepsis, adult respiratory distress syndrome (ARDS) and less frequently due to autonomic dysfunction or pulmonary embolism. There are only few studies which have used a large sample and have in detail analyzed the circumstances relating to death and the prognostic factors for the same in a cohort, including only mechanically ventilated patients.Objective:The objective of our study was to analyze the circumstances and factors related to mortality in mechanically ventilated patients of GBS.Materials and Methods:Case records of patients of GBS, satisfying National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) criteria, and requiring mechanical ventilation from 1984 to 2007, were analyzed.Results:A total of 273 GBS patients were managed with ventilatory support (190 men and 83 women) during the period. Besides symmetrical paralysis in all patients, bulbar palsy was present in 186 (68.1%), sensory involvement in 88 (32.2%) and symptomatic autonomic dysfunction in 72 (26.4%) patients. The mortality was 12.1%. The factors determining mortality were elderly age group (P=0.03), autonomic dysfunction (P=0.03), pulmonary complications (P=0.001), hypokalemia (P=0.001) and bleeding (P=0.001) from any site. Logistic regression analysis showed the risk of mortality was 4.69 times more when pneumonia was present, 2.44 times more when hypokalemia was present, and 3.14 times more when dysautonomia was present. The odds ratio for age was 0.97 indicating that a higher age was associated with a higher risk of mortality.Conclusions:Ventilator associated pulmonary complications, bleeding and hypokalemia especially in elderly patients require optimal surveillance and aggressive therapy at the earliest for reducing the mortality in this group of GBS patients.

show abstract

“…Previous studies imply age as a predictive factor for poor general outcome in GBS patients [3, 6, 13, 31, 33]. However, keeping in mind the higher mortality just described, it is of interest to address the question of whether older patients also have a poor neurological outcome once surviving the first, most critical period.…”

Section: Discussionmentioning

confidence: 96%

Mechanical Ventilation in Guillain-Barré Syndrome: Does Age Influence Functional Outcome?

et al. 2009

View full text Add to dashboard Cite

Purpose: To examine the effects of age on differences in the clinical course and functional outcome of mechanically ventilated Guillain-Barré syndrome (GBS) patients. Methods: 32 consecutive patients with GBS in need of mechanical ventilation were divided into two groups: (1) 15 patients <65 years, and (2) 17 patients ≥65 years. Length of ventilation, therapy, incidence of bulbar involvement, dysautonomia, preceding infections, need for tracheostomy, mortality, and functional outcome at 1-year follow-up using the Hughes outcome scale were analyzed. Results: The groups were comparable regarding treatment, lesion type, incidence of bulbar involvement, dysautonomia, preceding infections and duration of ventilation. The majority of patients (75%) received combination therapy (intravenous immunoglobulin and plasma exchange). Tracheostomy was performed in 91% of patients. Mortality was higher in older patients (41 vs. 7%; p = 0.02) and overall outcome worse (p = 0.05). Interestingly, once surviving the early, most critical period, older patients functionally recovered as well as younger patients (80% good outcome vs. 86%; p = 0.71). Conclusions: Despite all the advances in intensive care, mortality in older, ventilated GBS patients is still substantial. However, once they have survived the early, most critical period, older patients may recover as well as younger patients. Special care should therefore be taken to prevent and, if present, to vigorously treat complications commonly associated with intensive care treatment of severe GBS in elderly patients.

show abstract

Long-Term Outcome of Guillain-Barré Syndrome

Cited by 40 publications

References 41 publications

Factors associated with long-term functional outcomes and psychological sequelae in Guillain–Barre syndrome

Factors associated with long-term functional outcomes and psychological sequelae in Guillain–Barre syndrome

Mortality in mechanically ventilated patients of Guillain Barré Syndrome

Mechanical Ventilation in Guillain-Barré Syndrome: Does Age Influence Functional Outcome?

Contact Info

Product

Resources

About