Deltoid muscle strength and autonomic dysfunction as independent risk factors for invasive mechanical ventilation in patients with Guillain-Barré syndrome

• Published in: International journal of neuroscience 2023-12, Vol.ahead-of-print (ahead-of-print), p.1-8
• Main Authors: López-Hernández, Juan Carlos, Jorge de Saráchaga, Adib, Briseño-Godínez, María Eugenia, May-Mas, Raúl Nathanael, Bazán-Rodríguez, Lisette, León-Manriquez, Elizabeth, Cruz-Pérez, Jocelyn, Becerra-Hernández, Israel, Vargas-Cañas, Edwin Steven
• Format: Article
• Language: English
• Subjects: autonomic dysfunction; Guillain-Barré Syndrome; independent walk; invasive mechanical ventilation; prolonged mechanical ventilation
• ISSN: 0020-7454; 1563-5279; 1543-5245
• DOI: 10.1080/00207454.2022.2082963

Almost a third of patients with Guillain-Barré Syndrome (GBS) require mechanical ventilation, increasing mortality by 15-30% and proving poor functional outcomes. The Erasmus GBS Respiratory Insufficiency Score (EGRIS) is the most frequently used scale to assess probability of respiratory insufficiency within the first week of admission. We aim to determine other clinical and electrophysiological prognostic factors for invasive mechanical ventilation (IMV) in patients with GBS. A cross-sectional ambispective cohort study was carried out in a referral center in Mexico City, from January 2015 to December 2019. Baseline demographics, MRC score, Hughes scale, EGRIS, dysautonomia and nerve conduction studies were performed on admission in GBS patients that required IMV. A multivariable analysis for IMV and a survival analysis for independent walk in prolonged-IMV (>14 days) were performed. Forty-nine (32%) out of 153 GBS patients required IMV. Statistically significant prognostic factors in multivariable analysis were deltoid muscle strength ≤2 [OR 7.1 (1.6-31.1)], EGRIS [OR 2.5 (1.3-4.6)] and autonomic dysfunction [OR 6.6 (2.0-22.0)]. Electrodecrement