Guillain-Barré syndrome in southern Taiwan: clinical features, prognostic factors and therapeutic outcomes.
To determine the clinical features, prognostic factors, and therapeutic results of Guillain-Barré syndrome (GBS) in order to improve the therapeutic strategy for this disease. We retrospectively reviewed the electrodiagnostic study and medical records of patients with GBS admitted to Chang Gung Memorial Hospital, Kaohsiung, between January 1986 and December 2000. Outcomes and prognosis were followed-up after 1 year. Ninety-six patients were enrolled in this study. According to the clinical and electrophysiological findings, 77 patients were acute inflammatory demyelinating polyradiculoneuropathy, seven were Miller Fisher syndrome, and six were axonal forms, and six were unclassified. At a follow-up of 1 year, 61 patients (64%) recovered, 30 (31%) had residua and five (5%) died. Amongst these 30 had residua, including unassisted gait in 19, assisted gait in four, and wheel/bed bound in seven. According to the statistical analysis, disabilities at the nadir (P < 0.0001) and at admission (P = 0.014) were significant prognostic factors. Variables used for the stepwise logistic regression, and the results revealed that after analysis for all the above variables, only disability at the nadir (P < 0.0001) was independently associated with the treatment failure rate. Our study revealed 27% of cases in need of respiratory support during hospitalization, and 5% of hospital-treated patients die from the complications. Furthermore, 31% had residua at a follow-up of 1 year or more. If prognostic factors are considered, disability at the nadir during hospitalization demonstrates consistently poor therapeutic outcomes. Therefore, early diagnosis, choice of appropriate treatment, and preventing complications during acute stages are essential to maximize the potential for survival.
Cheng
B-C
BC
Department of Medicine, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
Chang
W-N
WN
Chang
C-S
CS
Chee
C-Y
CY
Huang
C-R
CR
Chen
J-B
JB
Chang
C-J
CJ
Hung
P-L
PL
Wang
K-W
KW
Chang
H-W
HW
Lu
C-H
CH
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012621:Seasons; D013624:Taiwan; D016896:Treatment Outcome