Early predictors of functional disability in Guillain–Barré Syndrome

Abstract

This study investigated the predictors of prognosis at admission and after the first month in Guillain-Barré syndrome (GBS) patients. This retrospective study used the electronic records of 81 GBS patients. Age, gender, previous GBS history, antecedent febrile illness and presence of cranial nerve dysfunction were recorded. Detailed neurological examinations, routine biochemical and haematological investigations, cerebrospinal fluid (CSF) analysis and electrophysiological studies, GBS subtypes and treatments were assessed. Hughes disability scores (HDSs) were evaluated at the end of the first day and first month. The GBS patient group included 44 male (54.3%) and 37 female (45.7%) patients. The mean age was 52.2 ± 18.5. The mean HDS score was 2.96 at admission and 1.94 at the end of the first month. Plasma sodium, albumin, and CSF protein levels were significantly correlated with low admission HDS scores (p = 0.03, p = 0.011, p = 0.036, and p < 0.001, respectively). Age, plasma sodium, albumin, neutrophil, neutrophil/lymphocyte ratio (NLR) levels, C-reactive protein (CRP) and CSF protein levels were significantly correlated with poor prognosis at the end of the first month (p < 0.05). Concomitant cranial nerve palsies were significantly correlated with low HDS scores (p = 0.011, p = 0.02) but antecedent events were not correlated with functional disability (p = 0.686, p = 0.413). Decreased albumin and sodium levels and increased CSF protein levels indicated poor GBS prognosis. Higher age, elevated NLR, and higher CRP levels indicated worse prognosis at the end of the first month. However, further studies are needed.