The clinical characteristics and short-term prognosis in elderly patients with Guillain–Barré syndrome

Abstract

To investigate the clinical characteristics and short-term prognosis of elderly patients with Guillain–Barré syndrome (GBS).We retrospectively analyzed the clinical data of adult GBS. According to the age, the enrolled subjects were divided into 2 groups, that is, patients ≥60 years (elderly group) and those aged 18 to 59 years (nonelderly group). The clinical characteristics and short-term prognosis of the patients in the 2 groups were compared.In total, 535 patients were enrolled. There were 67 patients fell into the elderly group with a mean age of 69 years old; while 468 patients fell into the nonelderly group with a mean age of 39 years old. We found that the elderly patients had significantly lower incidence of antecedent infections (49.3% vs 66.2%, P < 0.01). The time from onset to admission (5 vs 4 days, P < 0.05) and time from onset to nadir (7 vs 6 days, P < 0.05) were significantly longer in the elderly patients. It was noteworthy that more elderly patients were found with lymphocytopenia (55.4% vs 37.3%, P < 0.01), hyponatremia (25.0% vs 10.2%, P < 0.01), hypoalbuminemia (9.0% vs 2.6%, P < 0.05), and hyperglycemia (34.3% vs 15.2%, P < 0.01). Importantly, the elderly patients had longer duration of hospitalization (17 vs 14 days, P < 0.05), higher incidence of pneumonia (29.9% vs 18.8%, P < 0.05), and poorer short-term prognosis (58.2% vs 42.7%, P < 0.05). In patients with severe GBS, no significant differences were observed in disease severity, treatment modality, incidence of pneumonia, and duration of hospitalization between the 2 groups. However, more patients in the elderly group showed poor short-term prognosis (84.1% vs 63.8%, P < 0.01). Further, old age (≥60 years) (OR = 2.906, 95% CI: 1.174–7.194, P < 0.05) and lower Medical Research Council (MRC) score at nadir (OR = 0.948, 95% CI: 0.927–0.969, P < 0.01) were risk factors for poor short-term prognosis in severe GBS patients.The clinical characteristics and short-term prognosis of elderly patients with GBS are distinct from nonelderly adults. Old age (≥60 years) and lower nadir MRC score serve as predictor for poor short-term prognosis in severe GBS patients.

Clinical Profile, Functional Outcome, and Mortality of Guillain-Barre Syndrome: A Five-Year Tertiary Care Experience from Nepal

“…The prevalence of ascending paralysis in our study was similar to the data of Mateen J F et al from India [5] (100%) and Xiaowen Li et al (83.33%) from China [6]. Percentage of patients who needed mechanical ventilation due to respiratory failure was similar (13.9%) to that found by Zhang B et al from China [7]. However, it is less (55.9%) than data of study conducted by Yakoob MY et al at a tertiary care centre in Pakistan [8].…”

“…The mean age of patients with GBS having favourable outcome is less than that of unfavourable outcome group (16 vs. 23, p: 0.355); however, the difference was statistically insignificant. This was similar to the finding by Zhang B et al which showed the poor prognosis among patients with GBS of advancing age (69 vs. 39, p-0.008) [7]. Further studies are required to determine the age as one of the prognostic features of patients with GBS.…”

Guillain-Barre syndrome during COVID-19 pandemic: an overview of the reports

“…So far, only one child has been diagnosed with GBS following a coronavirus infection [ 50 ]. The clinical characteristics of nonelderly adult patients with GBS are distinct from those of the elderly [ 51 ]. However, since only one child has been diagnosed with GBS associated with COVID-19, no statement can be made in this regard at this time.…”

Incidence and mortality rates of Guillain‐Barré syndrome in Serbia

“…For instance, the study conducted by Zhang et al found a significantly lower incidence of antecedent infections in elderly patients with GBS, which may be caused by false positive diagnosis of GBS. 33 Some other studies have noted a decrease in the incidence rate in the age 40 to 49. 8,20,21 This was not the case in our research.…”