3 research outputs found
Risk factors for respiratory failure among hospitalized patients with Guillain–Barré syndrome
Background: Guillain–Barré 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 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. Resumen: Introducción: El sÃndrome de Guillain-Barré es una polineuropatÃa inflamatoria aguda que puede causar insuficiencia respiratoria. Evaluamos los factores de riesgo clÃnicos en el momento de la hospitalización. Métodos: Realizamos un estudio de una cohorte retrospectiva de pacientes con sÃndrome de Guillain-Barré hospitalizados en un centro de tercer nivel. Analizamos las caracterÃsticas sociodemográficas, sÃntomas de la enfermedad, fuerza muscular general y cervical (escala del Medical Research Council [MRC]), hallazgos electromiográficos, y resultados del análisis del lÃquido cefalorraquÃdeo. Calculamos el odds ratio (OR) sin ajustar y realizamos una regresión logÃstica exacta (OR ajustada) para evaluar la asociación entre los factores de riesgo y la insuficiencia respiratoria. Resultados: Trece de los 113 pacientes incluidos (12%) presentó insuficiencia respiratoria. Los análisis no ajustados mostraron una asociación entre mayor riesgo de insuficiencia respiratoria y la afectación de cualquier par craneal (OR: 14,7; IC 95%, 1,8-117,1), parálisis facial (OR: 17,3; IC 95%, 2,2-138,0) y debilidad bulbar (OR: 10,7; IC 95%, 2,3-50,0). Unas puntuaciones más bajas en la MRC-total (puntuaciones 3) se asociaron de forma independiente con la insuficiencia respiratoria. Conclusiones: La presencia de debilidad bulbar y cervical en el momento de la hospitalización es un factor de riesgo de insuficiencia respiratoria en pacientes con sÃndrome de Guillain-Barré. Estos hallazgos pueden servir de guÃa para el manejo de los pacientes con mayor riesgo de presentar dicha complicación