Guillain-Barré syndrome: a prospective, population-based incidence and outcome survey.
OBJECTIVE
The authors evaluated the incidence and long-term prognostic factors of Guillain-Barré syndrome (GBS) in a prospective, population-based study.


METHODS
Patients with GBS diagnosed according to National Institute of Neurological and Communicative Disorders and Stroke criteria in the 2-year period 1995 to 1996 in two Italian regions were prospectively followed up for 2 years after onset of GBS.


RESULTS
A total of 120 patients were found, corresponding to a crude annual incidence rate of 1.36/100,000 population (95% CI, 1.13 to 1.63). A total of 7 (5.8%) patients, all but one with axonal or mixed EMG pattern, died acutely within 30 days from the onset of the disease. Acute mortality was due to respiratory involvement and intensive care unit complications. In multivariate analysis, a worse 2-year outcome (Hughes score >or=2) was related to a higher Hughes grade at nadir, axonal or mixed EMG, age >or=50 years, and absence of respiratory infections preceding GBS. The persistence of disability 2 years after the acute phase was related to axonal involvement and a worse status at nadir.


CONCLUSIONS
After adjustment to US population, the incidence rates for GBS from different countries showed no significant differences. Both acute mortality and long-term disability in GBS seem to be related to an axonal involvement and a Hughes grade >or=2 at nadir.
Chiò
A
A
Department of Neuroscience, University of Turin, San Giovanni Battista Hospital, Italy. achio@usa.net
Cocito
D
D
Leone
M
M
Giordana
M T
MT
Mora
G
G
Mutani
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D018450:Disease Progression; D004568:Electrodiagnosis; D005260:Female; D005500:Follow-Up Studies; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology