Risk factors for respiratory failure among hospitalized patients with Guillain-Barré syndrome

被引:1
|
作者
Maskin, L. P. [1 ]
Wilken, M. [2 ]
Lucci, F. Rodriguez [1 ]
Wisnivesky, J. P. [3 ,4 ]
Barroso, F. [2 ]
Wainsztein, N. [1 ]
机构
[1] FLENI, Intens Care Unit, Buenos Aires, Argentina
[2] FLENI, Dept Neurol, Buenos Aires, Argentina
[3] Icahn Sch Med Mt Sinai, Div Gen Internal Med, New York, NY USA
[4] Icahn Sch Med Mt Sinai, Div Pulm & Crit Care Med, New York, NY USA
来源
NEUROLOGIA | 2024年 / 39卷 / 01期
关键词
Guillain-Barr & eacute; syndrome; Neck muscle; weakness; MRC sum score; Respiratory failure; MECHANICAL VENTILATION; PREDICTORS;
D O I
10.1016/j.nrl.2021.04.011
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Guillain-Barr & eacute; syndrome (GBS) is an acute inflammatory polyneuropathy that can lead to respiratory failure. In this study, we evaluate early clinical risk factors for respiratory failure at the time of hospital admission. Methods: We studied a retrospective cohort of patients with GBS admitted to a tertiary care center. The potential risk factors studied were sociodemographic characteristics, GBS symptoms, overall and cervical muscle weakness (Medical Research Council [MRC] scores), electromyography findings, and cerebrospinal fluid analysis findings. Unadjusted odds ratios (OR) were calculated and exact logistic regression analysis (adjusted OR) performed to assess the association between baseline risk factors and respiratory failure. Results: Overall, 13 of 113 (12%) patients included in the study developed respiratory failure. Unadjusted analyses showed that involvement of any cranial nerve (OR: 14.7; 95% CI, 1.8-117.1), facial palsy (OR: 17.3; 95% CI, 2.2-138.0), and bulbar weakness (OR: 10.7; 95% CI, 2.3-50.0) were associated with increased risk of respiratory failure. Lower MRC sum scores (for scores <30, OR: 14.0; 95% CI, 1.54-127.2) and neck MRC scores (for scores <3, OR: 21.0; 95% CI, 3.5-125.2) were associated with higher likelihood of respiratory failure. Adjusted analyses showed that presence of bulbar weakness (OR: 7.6; 95% CI, 1.3-43.0) and low neck MRC scores (scores <3, OR: 9.2; 95% CI, 3.5-125.2, vs scores >3) were independently associated with respiratory failure. Conclusions: Bulbar and neck muscle weakness at admission are clinical predictors of increased risk of respiratory failure in patients with GBS. These findings could guide the adequate management of high-risk patients. (c) 2021 Sociedad Espanola ola de Neurolog<acute accent>& imath;a. Published by Elsevier Espana, a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
引用
收藏
页码:36 / 42
页数:7
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