4.2 Article

Rate of progression of Guillain-Barre syndrome is not associated with the short-term outcome of the disease

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IRISH JOURNAL OF MEDICAL SCIENCE
卷 190, 期 1, 页码 357-361

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SPRINGER LONDON LTD
DOI: 10.1007/s11845-020-02310-7

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Functional outcome; Guillain-Barre syndrome; Nadir; Progression rate

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This study found that GBS patients were divided into rapid, gradual, and slow progression groups according to the progression rate, with rapid-onset GBS patients more likely to have axonal variants. However, faster progression of GBS does not necessarily lead to a poorer short-term functional outcome of the disease.
Introduction There are no many data on association between progression rate of Guillain-Barre syndrome (GBS) and disease outcome. Aim The aim of our study was to analyze short-term outcome of GBS in relation to the rate of disease progression. Methods Our retrospective study included patients diagnosed with GBS in seven tertiary healthcare centers from 2009 to 2014. According to the rate of disease progression from onset of symptoms to the nadir, patients were divided in three groups: rapid-onset GBS (nadir reached in maximum 48 h), gradual-onset (nadir reached in three to 14 days), and slow-onset (nadir in 15 to 28 days). GBS disability scale (GDS) was used to assess functional disability at nadir and on discharge. Results Among 380 patients included in the study, 24 (6.3%) patients had rapid-onset, 274 (72.1%) gradual-onset, and 82 (21.6%) slow-onset GBS. Time from the onset of the disease to the hospital admission was much shorter in faster-onset forms (3.0 +/- 4.1 days in rapid-onset vs. 6.8 +/- 9.5 days in gradual-onset and 21.0 +/- 9.6 days in slow-onset GBS,p < 0.01). Preceding events were less commonly identified in slow-onset forms. Patients with rapid-onset GBS were more likely to have axonal variants (p < 0.05). All three groups of patients were treated in a similar way, and there were no differences in GDS score at nadir (p > 0.05) and on discharge (p > 0.05) and no differences in the duration of hospital stay. Conclusion Faster progression of GBS does not imply a poorer short-term functional outcome of the disease.

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