Clinical Profile and Outcomes of patients admitted with Guillain-Barre Syndrome to a Specialized Tertiary Teaching Hospital in Ethiopia- a retrospective cohort analysis

Abstract

Background: Despite the increased complications associated with Guillain-Barre Syndrome (GBS); there is scarce information on clinical characteristics and outcomes associated with the disease. The objective is to assess the clinical profile and outcomes of patients admitted with GBS at a tertiary hospital.

Methods: This was a retrospective cohort study that analyzed non-electronic medical files of patients with the diagnosis of GBS during the period from May 2008 to August 2016 at a tertiary-level hospital. Guillain-Barre Syndrome was defined according to the National Institute of Neurological and Communicative Disorders and Stroke (NINDS). 

Results: In total, 82 patients’ files were included in the study and their median age was 29.5 years (IQR 20-36) and 62.2% of the patients were male. Antecedent events were seen in 36 (43.9%) patients and 15 (18.3%) had prior vaccination history; 93% of the latter had an anti-rabies vaccine.  Nearly 90.0% of the GBS patients presented with extremity weakness that involved all extremities in almost 90.0%. Albumino-cytologic dissociation was seen in 77.6% of the analyzed cerebrospinal fluid. The mortality rate was 11.0% and was significantly higher in those with dysautonomia (30.8% vs. 1.8%,), mechanically ventilated (36.4% vs. 1.8%), respiratory failure (28.6% vs. 1.9%) and those with a longer median hospital stay [20 days (IQR 12-31) vs. 11 days (5-23), P=0.03]. In adjusted analysis, respiratory failure and a longer hospital predicted mortality.

Conclusion: Our study demonstrated a clinical profile comparable to the previous; however, the in-hospital mortality rate was lower.  Early mechanical ventilation and treatment of complications are recommended to improve the treatment outcomes.