Predictors and Risk Factors of Severity of GBS, the Requirement for Mechanical Ventilation and Poor Short-Term Prognosis of Severe GBS

Abstract

Background/Objective:It is still an extraordiarily exigent thing to early recognize the severity, therapeutic method and prognisis of Guillain-Barré syndrome (GBS). Our research’s goal is to investigate the clinical predictive factors indicating severity of GBS and the requirement for mechanical ventilation(MV) in severe patients with GBS, and to explore the identification of modifiable risk factors for predicting poor short-run outcome of severe GBS. Methods: A total of 155 patients were included in a cohort of GBS patients admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University between 2014 and 2020. Demographic, clinical, therapeutical and evolutionary data were collected. Neurological testing which used standardized data collection were carried out by the same investigators on the whole study period. Comparion of the results were implemented by single and multiple regression analysis.Result: Of 155 patients, 66 patients were severe GBS, of which twenty-nine patients (18.7%) needed MV. Significant clinical predictors for severe GBS were recent history of surgery, time from onset to admission, Medical Research Council(MRC) sum score on admission, autonomic dysfunction, cranial nerve impairment(glossopharyngeal, facial, Oculomotor and/or abducent nerve deficits) and elevated liver enzyme levels were significantly bound up with severity scores(p<0.05). With regard to risk factors of MV in severe GBS, univariate logistic analysis indicated presence of cranial nerve involvement, autonomic dysfunction, MRC score at nadir, elevated liver enzymes and pneumonia were significantly different(p<0.05); Multivariate analysis determined that MRC score at nadir and autonomic dysfunction were also considered to be predictors for MV in severe GBS(p<0.05).As to prognostic of factors, recent history of surgery, MRC score at nadir, the requirement for MV, MRC score at admission and pneumonia during hospitalization were predictors of poor short-run outcome in severe patients with GBS by univariate logistic analysis, and that the nadir MRC score and the requirement for MV were identically proved as clinic parameters of unfavourable prognosis by multivariate logistic analysis (p<0.05) .Conclusions: Clinical risk factors of severity in GBS, the requirement of MV and unfavourable short-run prognosis in severe GBS were evident. Recent history of surgery is also a predictor for severity in GBS patients.