Predictors of poor outcome in GBS
What are the predictors of severe disease and poorer outcome in patients with Guillain Barre syndrome?
- Old age
- Rapid onset of severe tetraparesis
- Need for early artificial ventilation
- Severely decreased CMAPs (<20% of normal)
- Acute motor-sensory axonal form of the disease
There are conflicting data as to whether evidence of preceding C. jejuni infection or presence of anti-GM1 antibodies is a predictor of disease severity or outcome.
Mortality is greatest in the elderly and those with comorbid illnesses. Of the complications occurring during intensive care unit (ICU) admission, one study found that the development of ileus and risk of bowel perforation was most strongly associated with mortality.
Recovery in ventilated patients with GBS may be prolonged, and final prognosis may require 2 or more years of follow-up.
The Erasmus GBS Outcome Score (EGOS) and modified EGOS (mEGOS) has been developed to provide a better predictor of poor prognosis in patients with GBS.
This study found that patients with preceding diarrhea, older age, and low Medical Research Council (MRC) sumscore (a measure of weakness) at presentation had the worst outcomes.