Clinical features and real-world outcomes of Guillain–Barré syndrome in the Philippines

Abstract

ABSTRACT Background Our study aimed to determine the profile of Guillain–Barré syndrome (GBS) in the Philippines, compare the outcomes who received intravenous immunoglobulin (IVIg) and therapeutic plasma exchange (TPE), and determine the factors related to hospital stay and late motor recovery. Methods We conducted a retrospective cohort study of adult GBS patients admitted to the Philippine General Hospital from 2009 to 2019. Results We included 105 patients with confirmed GBS diagnoses. The median age was 43 years (interquartile range 32 to 56); the female-to-male ratio was 1.62:1; the predominant variant was acute inflammatory demyelinating polyneuropathy (n = 40, 38.1%). The difference in outcomes of patients in the IVIg (n = 44) and TPE (n = 24) groups (walking with aid/GBS-disability scores/ventilator dependency at 1 month, duration dependent on the ventilator, intensive care unit stay, and hospital stay) were not statistically significant, except for mild disability at 1 month (p = 0.009). Pneumonia, urinary tract infection, and dysautonomia were significantly related to a prolonged hospital stay. No predetermined variables were associated with late motor recovery. After adjusting for age and sex, the cumulative hazard risk for late motor recovery was 0.69 (95% CI 0.27–1.74). Conclusion Our study presented the first comprehensive information regarding the features and outcomes of GBS patients in the Philippines. Abbreviations AIDP – Acute inflammatory demyelinating polyneuropathy; AMAN – Acute motor axonal neuropathy; AMSAN – Acute motor and sensory axonal neuropathy; GBS – Guillain–Barré syndrome; GBS-DS – Guillain–Barré syndrome disability scale; ICU – Intensive care unit; IVIg – Intravenous immunoglobulin; MFS – Miller–Fisher syndrome; PGH – Philippine General Hospital; TPE – Therapeutic plasma exchange.