Early Disability Predictors of Guillain–Barre Syndrome

Abstract

Objective: Guillain–Barre syndrome (GBS) still carries non-negligible morbidity and mortality. In this study, we aimed to evaluate the effect of demographic data, clinical findings, serum and cerebrospinal fluid (CSF) laboratory tests on detecting disability in the early period in GBS patients. Material and Methods: In our study, the records of 324 cases followed up with the diagnosis of GBS between January 1, 2018 and December 31, 2021 were retrospectively reviewed. Demographic data, complaints at admission, comorbid diseases, antecedent infections, neurological examination findings, Guillain–Barre disability score (GDSs) at day 1 and 1 month, serum and CSF laboratory parameters, electromyoneurography results, GBS subtypes, complications, treatments and prognoses were recorded. Results: In our study, which included 121 GBS patients, the median age was 58 (20-87) years. Of all patients, 60.3% (n:73) were male. The mean GDSs was 3 at admission and 2 at the end of the frst month. When the laboratory data were examined, C-reactive protein (CRP), cerebrospinal fluid protein were found to be high and vitamin D found to be low in GBS. Higher age, antecedent infections, intensive care unit (ICU) admission, need of mechanical ventilation (MV) support, presence of complications, high plasma CRP levels, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were signifcantly correlated with worse disability at day 1 and in the first month in GBS patients. Conclusion: Higher age, cranial nerve involvement, presence of antecedent infections, severe clinical onset (ICU and MV support), occurance of complications and increased inflammation markers (CRP, NLR, PLR) are early indicators of severe disability in GBS.