Rapidly Progressive Guillain-Barré Syndrome (GBS) as a Critical Predictor of Early Mechanical Ventilation and...

Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy that can progress rapidly, often leading to respiratory failure and prolonged hospitalization. Identifying rapidly progressive GBS is crucial for prognostication and timely intervention.

This study aims to evaluate the clinical progression, need for mechanical ventilation, and hospital stay duration in patients with GBS.

This is a retrospective observational study of 51 patients diagnosed with GBS. Demographic profile, antecedent events, variants of GBS, treatment offered, need for mechanical ventilation, and duration of hospital stay were studied.

Fifty-one patients with a diagnosis of GBS were included in the study. The mean age of the patients was 36 years, ranging from five to 68 years. The incidence of GBS was higher among males (74.5%) with a male-to-female ratio of 2.92. The mean time of presentation was 10.41±10.42 days (range 1-45 days). Among these, 27 patients (52.9%) presented within a week of symptom onset, while 24 patients (47.1%) presented after a week. Respiratory involvement was seen among 11 Patients (21.6%), while autonomic involvement was seen among nine patients (17.6%). In nerve conduction, acute motor axonal neuropathy (AMAN) was a common variant (31.4%), followed by acute inflammatory demyelinating polyneuropathy (AIDP) (25.5%). Twenty-eight patients (54.9%) received IVIG. Mechanical ventilation was required by 13.7% patients. However, three patients (5.9%) succumbed. Correlation of duration of stay with respect to time of presentation showed a statistically significant negative correlation, suggesting that early presentation is related to severe neurological symptoms, longer hospital stay, and higher respiratory or autonomic dysfunction.

The most common GBS variant in the demographic sampled was the AMAN variant, followed by AIDP. Patients with severe diseases complicated by severe paralytic illness with respiratory and autonomic involvement presented early and had a longer duration of hospital stay. These patients are at high risk of deterioration and, therefore, need to be appropriately managed with timely diagnosis and treatment.