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Published on: December 9, 2015
Patterns of Seasonality and Subtype-Linked Outcomes of Pediatric Guillain-Barré Syndrome ICU Admissions: A 10-Year
Rohini M Surve1, Prachi Sharma2, Roshan Nisal2
1Department of Neuroanesthesia and Neurocritical Care, Neurocentre Faculty Block, National Institute of Mental Health and Neurosciences (NIMHANS), 3Rd Floor, Hosur Road, Bengaluru, Karnataka, 560029, India. rohinigondhule@gmail.com.
Objective:
To evaluate the seasonal variation in Guillain-Barré Syndrome (GBS) subtype distribution and its association with clinical outcomes in pediatric patients requiring intensive care unit (ICU) admission.
Methods:
An audit of pediatric patients with GBS admitted to the neuro-ICU of a tertiary center in Southern India between 2008 and 2018 was conducted. Seasonal distribution was defined as per meteorological classification: summer (March-May), monsoon (June-September), post-monsoon (October-November), and winter (December-February). Clinical subtypes, treatment, and outcomes, including length of mechanical ventilation (LOMV), ICU stay (LOIS), hospital stay (LOHS), and Hughes disability scores, were analyzed across seasons.
Results:
Among 75 patients, the highest admissions occurred during the monsoon (n = 29). Acute motor axonal neuropathy (AMAN) was more frequent in monsoon, while acute inflammatory demyelinating polyneuropathy (AIDP) was common in winter and summer. Across the full cohort, no statistically significant seasonal differences were found in the outcomes. However, within the AMAN subtype, LOHS was significantly longer in summer compared to post-monsoon (P = 0.005). Axonal variants showed higher rates of intubation and severe disability (Hughes disability score > 3), while AIDP had milder outcomes.
Conclusion:
Seasonal clustering of GBS subtypes was observed, with axonal variants more common during the monsoon. However, seasonal variation did not significantly impact the overall clinical outcomes in pediatric ICU patients.
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