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Reliability and validity of prognostic indicators for Guillain-Barré syndrome in children
Huang Qinrong1, Chen Yuxia1, Liu Ling1
1Department of Rehabilitation Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China.
Insights
The modified Erasmus GBS Outcome Score (mEGOS) and Erasmus GBS Outcome Score (EGOS) reliably predict outcomes for pediatric Guillain-Barré syndrome (GBS) patients. The Erasmus GBS Respiratory Insufficiency Score (EGRIS) effectively predicts the need for mechanical ventilation.
Area of Science:
- Neurology
- Clinical Medicine
- Pediatrics
Background:
- Guillain-Barré syndrome (GBS) is a rare neurological disorder affecting children.
- Accurate prognostic predictors are crucial for managing pediatric GBS cases.
- Understanding clinical characteristics aids in early diagnosis and treatment.
Purpose of the Study:
- To investigate the clinical features of Guillain-Barré syndrome in Chinese children.
- To evaluate the prognostic value of the Erasmus GBS Outcome Score (EGOS), modified EGOS (mEGOS), and Erasmus GBS Respiratory Insufficiency Score (EGRIS).
- To assess the predictive capability of these scores for clinical outcomes and mechanical ventilation requirements.
Main Methods:
- Retrospective analysis of clinical data from 142 pediatric GBS patients.
- Evaluation of EGOS, mEGOS, GBS disability score (GDS), modified Rankin Scale (MRS), and EGRIS.
- Correlation analysis between scores and outcomes such as independent ambulation, need for assistance, and mechanical ventilation.
Main Results:
- Most pediatric GBS patients achieved independent ambulation and could manage without assistance at 6 months.
- 12.68% of patients required mechanical ventilation.
- EGRIS was significantly higher in patients requiring mechanical ventilation (median 6 vs. 3, p < 0.001).
Conclusions:
- mEGOS and EGOS are validated prognostic indicators for pediatric GBS patients in China.
- EGRIS is a valuable tool for predicting mechanical ventilation needs in the acute phase of GBS.
- An EGRIS score of ≥5 suggests a high risk of requiring mechanical ventilation.
Aim:
To explore the clinical characteristics and prognostic predictors of Guillain-Barré syndrome (GBS) in Chinese paediatric patients.
Method:
The clinical features of children with GBS hospitalized in the Children's Hospital of Chongqing Medical University were summarized retrospectively. The correlation between the Erasmus GBS Outcome Score (EGOS)/modified Erasmus GBS Outcome Score (mEGOS), GBS disability score (GDS)/modified Rankin Scale (MRS), Erasmus GBS Respiratory Insufficiency Score (EGRIS), and mechanical ventilation were evaluated.
Results:
One hundred forty-two patients (86 males, 56 females; median 62.50 months [interquartile range 41.00-97.50]) with classic GBS were enrolled in the study. In the present GBS cohort, 134 (94.37%) patients could walk independently (GDS ≤2) and 121 (85.21%) could manage without assistance (MRS ≤2) at 6 months. Eighteen (12.68%) patients with GBS required mechanical ventilation. The performance of mEGOS on admission, mEGOS on day 7, and EGOS-predicted GDS outcome at 4 weeks, 3 months, and 6 months in the paediatric patients with GBS admitted within 2 weeks of disease onset and that of the MRS outcome were evaluated. The EGRIS in individuals who required mechanical ventilation was significantly higher than in patients without mechanical ventilation (median = 6 vs median = 3, p < 0.001).
Interpretation:
In Chinese paediatric patients with GBS who were admitted 2 weeks after disease onset, the mEGOS and EGOS are validated indicators for the prediction of clinical outcomes 6 months after onset. EGRIS is helpful in predicting the implementation of mechanical ventilation in the acute phase.
What This Paper Adds:
The Erasmus Guillain-Barré syndrome (GBS) Outcome Score (EGOS) and modified EGOS are reliable prognostic predictors in paediatric patients with GBS. The Erasmus GBS Respiratory Insufficiency Score (EGRIS) is an effective predictor of mechanical ventilation in paediatric patients with GBS. An EGRIS of ≥5 indicates a high risk of mechanical ventilation in the acute phase.
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