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Predictors of respiratory failure in Guillain-Barré syndrome: a 22 year cohort study from a single Italian centre.
Galassi, Giuliana; Mazzoli, Marco; Ariatti, Alessandra; Bedin, Roberta; Marzullo, Donato; Bastia, Elisabetta; Agnoletto, Virginia; Gozzi, Manuela; Valzania, Franco; Meletti, Stefano; Marchioni, Alessandro.
Afiliación
  • Galassi G; Department of Biomedical, Metabolic and Neural Sciences, University Hospitals, Modena, Italy.
  • Mazzoli M; Department of Biomedical, Metabolic and Neural Sciences, University Hospitals, Modena, Italy.
  • Ariatti A; Department of Biomedical, Metabolic and Neural Sciences, University Hospitals, Modena, Italy.
  • Bedin R; Department of Biomedical, Metabolic and Neural Sciences, University Hospitals, Modena, Italy.
  • Marzullo D; Department of Biomedical, Metabolic and Neural Sciences, University Hospitals, Modena, Italy.
  • Bastia E; Division of Cardiology, Baggiovara Hospital, Modena, Italy.
  • Agnoletto V; Division of Cardiology, Baggiovara Hospital, Modena, Italy.
  • Gozzi M; Department of Imaging, University Hospitals of Modena, Modena, Italy.
  • Valzania F; Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
  • Meletti S; Department of Biomedical, Metabolic and Neural Sciences, University Hospitals, Modena, Italy.
  • Marchioni A; Respiratory Disease Unit, Department of Medical and Surgical Sciences, University Hospitals of Modena, Modena, Italy.
Eur J Neurol ; 31(1): e16090, 2024 01.
Article en En | MEDLINE | ID: mdl-37823704
ABSTRACT
BACKGROUND AND

PURPOSE:

The study aimed to identify predictors of respiratory failure leading to mechanical ventilation (MV) and tracheostomy in Guillain-Barré syndrome (GBS).

METHODS:

Two hundred and thirty adult cases admitted to the Neurology Unit of Modena, Italy, between January 2000 and December 2021 were studied. A cut-off of MV starting within 8 weeks from onset of weakness was used. Univariable, multivariable logistic and Cox regression analyses were used to determine which pre-specified clinical and diagnostic characteristics were capable of predicting MV and tracheostomy, due to weaning failure. The model was internally validated within the full cohort. The Erasmus GBS Respiratory Insufficiency Score was retrospectively applied.

RESULTS:

One hundred and seventy-six cases (76.5%) were classified as classical sensorimotor GBS and 54 (23.4%) as variants. Thirty-two patients (13.9%) needed MV 84.3% required respiratory support within 7 days. Independent predictors of respiratory failure and MV were older age, facial, bulbar, neck flexor weakness, dysautonomia, axonal electrophysiological subtype, cardiovascular comorbidities and higher disability score at entry. There was no association with abnormal spinal fluid parameters nor with positive serology for recent infections. Twenty-two patients (68.7%) were ventilated for more than 7 days; 4.7% died within 8 weeks. The patients who required MV were treated more often with plasma exchange. Independent predictors of tracheostomy due to weaning trial failure were facial, bulbar, neck flexor weakness, autonomic dysfunction, associated cardiovascular morbidities and axonal electrophysiological subtype on nerve conduction study.

CONCLUSIONS:

Our study indicates distinct predictors of MV and tracheostomy in GBS patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Síndrome de Guillain-Barré Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Respiratoria / Síndrome de Guillain-Barré Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido