Objectives
Although a locally published paper clinically characterized Guillain Barre syndrome (GBS) patients admitted in one of the Philippines' largest hospitals, extensive identification of risk factors associated with poor outcomes has yet to be done. The main objective of this study is to determine the possible association between several outcome measures and GBS risk factors using different regression analytic methods of secondary data.
Methods
Data from 71 GBS patients from our previous study about possible determinants related to dysautonomia were analyzed. To determine the possible factors associated with binary outcomes like status on discharge, ambulation at 1 month, and presence or absence of pneumonia during admission, multiple logistic regression analysis was used while factors associated with continuous outcome like onset of motor recovery, multiple linear regression analysis was utilized. For failure outcomes with survival times, including days to dysautonomia or intubation, a cox proportional hazard model or its variants were utilized.
Results
Using dysautonomia as the main independent variable, and age and presence of pneumonia prior to GBS diagnosis as the possible confounders, no association between dysautonomia and different outcome parameters was noted whether unadjusted or adjusted odds ratio (OR) was used. Compared to other GBS variants, the odds of being bed or wheelchair bound on discharge was 10 times (95% CI: 1.7–57.7, p = 0.01) when a patient has the axonal variant of GBS. Moreover, the same cohort was 20 times (95% CI: 3.2–125.0, p < 0.01) more likely to be nonambulatory in 1 month when compared to other GBS variants. In terms of types of treatment, no association between the type of treatment and different outcome variables was noted whether uncontrolled or factors such as sex, days until admission, expanded disability status scale (EDSS) at admission, initial GBS-DS, presence of pneumonia, proportion of patients with Brighton diagnostic level 1, and GBS type were controlled.
Conclusion
In the Philippines, the type of GBS is found to be associated with poor prognosis. Nevertheless, when possible confounders were controlled, the type of GBS, dysautonomia, and type of treatment were noted not to affect the outcomes. The insufficient power of the study may explain the negative results of the commonly associated factors of poor prognosis.
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