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High mortality from Guillain-Barré syndrome in Bangladesh

Tanveen Ishaque1,2, Mohammad B Islam1,3, Gulshan Ara1

  • 1Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka, Bangladesh.

Journal of the Peripheral Nervous System : JPNS
|April 28, 2017
PubMed

Insights

Guillain-Barré syndrome (GBS) in Bangladesh has a 12% mortality rate, primarily due to lack of ventilator support and disease severity. Understanding these risk factors is crucial for improving patient outcomes in the region.

Area of Science:

  • Neurology
  • Epidemiology
  • Critical Care Medicine

Background:

  • Guillain-Barré syndrome (GBS) presents a significant health challenge in Bangladesh with high incidence and poor outcomes.
  • Mortality patterns and associated risk factors for GBS in Bangladesh remain underexplored.

Purpose of the Study:

  • To investigate the frequency, timing, and specific risk factors contributing to GBS-related deaths in Bangladesh.
  • To identify key determinants of mortality in GBS patients admitted to a tertiary care hospital.

Main Methods:

  • A prospective study was conducted on 407 GBS patients at Dhaka Medical College Hospital from 2010 to 2013.
  • Comparative analysis of deceased versus surviving patients identified risk factors.
  • Cox regression modeling was employed to adjust for potential confounders.

Main Results:

  • The study recorded a GBS mortality rate of 12% (50 out of 407 patients), with a median time to death of 18 days post-weakness onset.
  • Key risk factors for mortality included lack of ventilator support (HR: 11.9), age ≥40 years (HR: 5.9), longer progressive phase >8 days (HR: 2.06), mechanical ventilation (HR: 2.3), autonomic dysfunction (HR: 1.9), and bulbar nerve involvement (HR: 5.4).
  • Unavailability of ventilators contributed to 20% of GBS deaths.

Conclusions:

  • GBS in Bangladesh is associated with substantial mortality, significantly influenced by the lack of adequate ventilator support.
  • Disease severity, prolonged disease progression, autonomic dysfunction, and bulbar involvement are critical factors impacting GBS patient survival in this population.

Keywords:
BangladeshGuillain-Barré syndromeautonomic dysfunctionmechanical ventilationmortality

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