High mortality from Guillain ‐Barré syndrome in Bangladesh

Abstract Although Guillain‐Barré syndrome (GBS) has higher incidence and poor outcome in Bangladesh, mortality from GBS in Bangladesh has never been explored before. We sought to explore the frequency, timing and risk factors for deaths from GBS in Bangladesh. We conducted a prospective study on 407 GBS patients who were admitted to Dhaka Medical College Hospital, Dhaka, Bangladesh from 2010 to 2013. We compared deceased and alive patients to identify risk factors. Cox regression model was used to adjust for confounders. Out of 407 GBS patients, 50 (12%) died, with the median time interval between the onset of weakness and death of 18 days. Among the fatal cases, 24 (48%) were ≥ 40 years, 36 (72%) had a MRC sum score ≤ 20 at entry, 33 (66%) had a progressive phase <8 days and 27 (54%) required ventilation support. Ten patients (20%) died due to unavailability of ventilator. The strongest risk factor for deaths was lack of ventilator support when it was required (HR: 11.9; 95% CI: 4.6‐30.7). Other risk factors for death included age ≥40 year (HR: 5.9; 95% CI: 2.1‐16.7), mechanical ventilation (HR: 2.3; 95% CI: 1.02‐5.2), longer progressive phase (>8days) (HR: 2.06; 95% CI: 1.1‐ 3.8), autonomic dysfunction (HR: 1.9; 95% CI: 1.05‐3.6) and bulbar nerve involvement (HR: 5.4; 95% CI: 1.5‐19.2). In Bangladesh, GBS is associated with higher mortality rates which, is related to lack of ventilator support, disease severity, longer progressive ph...
Source: Journal of the Peripheral Nervous System - Category: Neurology Authors: Tags: RESEARCH REPORTS Source Type: research