1. Outcomes of Guillain–Barré Syndrome Patients Admitted to Intensive Care Unit in Tertiary Care Hospital
- Author
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Muhammad Jaffar Khan, Iftikhar Ali, Muhammad Ijaz, Faheemullah Khan, Wiqar Ahmad, and Asadullah Khan
- Subjects
medicine.medical_specialty ,lcsh:R5-920 ,Guillain-Barre syndrome ,business.industry ,medicine.medical_treatment ,Tertiary care hospital ,medicine.disease ,Intensive care unit ,Guillain–Barré syndrome ,mortality ,law.invention ,plasmapheresis ,law ,Emergency medicine ,Medicine ,Plasmapheresis ,business ,lcsh:Medicine (General) - Abstract
Despite the availability of plasmapheresis and intravenous immunoglobulin, the mortality and long-term morbidity from Guillain–Barré Syndrome (GBS) remains significant. This study aimed to determine the short-term outcomes in patients with GBS admitted to an intensive care unit. A total of 27 patients with a mean age of 31.67 ± 15.88 years were prospectively followed for 4 weeks after admission. Overall muscle power was graded using Medical Research Council (MRC) score 0–5, GBS disability was graded according to the Hughes scale, and tendon reflexes and features of dysautonomia were also noted. Plasma and cerebrospinal fluid biochemical parameters were analysed. Plasmapheresis sessions were done in all except one patient. Seven patients (26%) who died during follow-up showed a significantly higher proportion of dysautonomia features compared to those who survived. However, muscle power and plasma and cerebrospinal fluid biochemical features were similar between the two groups. Increasing age was associated with poor outcome [Unadjusted odds ratio (OR) 0.9270, 95% confidence interval (CI) 0.8598–0.9995, p = 0.027]. Plasmapheresis had no impact on the improvement of overall MRC score. Platelet count reduced significantly with plasmapheresis sessions (p = 0.014). Survival rate of patients decreased with prolonged preceding illness, hospital stay, and duration of mechanical ventilation >10 days. Only three patients were capable of independent survival at the end of 4 weeks’ follow-up. Plasmapheresis-only treatment does not improve overall MRC score in the short term in patients presenting with low MRC score.
- Published
- 2019