The Role of Serum Albumin as a Prognostic Marker in Guillain-Barré Syndrome: A Systematic Review

Guillain-Barré syndrome (GBS) is an immune-mediated neuropathy typically triggered by infection. Prognosis is primarily based on clinical features and established scoring systems. Serum albumin, a biomarker reduced in systemic inflammation, has demonstrated prognostic value in various conditions. This study aims to investigate the correlation between serum albumin levels and clinical outcomes in patients with GBS. Following PRISMA guidelines, a systematic review was conducted using PubMed, ScienceDirect, Google Scholar, and EuropePMC, covering all records up to April 2025. The search strategy included terms such as "Guillain-Barré Syndrome", "Albumin", and "Outcome" along with relevant MeSH terms. Studies eligible for inclusion were cohort studies and randomized controlled trials (RCT) evaluating the association between serum albumin levels and GBS. Primary outcome was GBS disability scores (GBS-DS), with secondary outcomes including Medical Research Council (MRC) scores and the need for mechanical ventilation (MV). Risk of bias was assessed using Risk of Bias of Non-Randomized Study of Exposure (ROBINS-E). Fifteen studies including 1,441 patients met the criteria for inclusion. Lower albumin levels at both admission and follow-up were strongly associated with higher GBS scores, lower MRC scores, and the necessity for mechanical ventilation. Conversely, elevated albumin levels correlated with better clinical outcomes. According to the ROBINS-E assessment, four studies were rated as having a "some concerns" risk of bias, while the remaining eleven studies were considered low risk. Serum albumin concentration is a useful prognostic indicator in patients with GBS, with lower levels significantly associated with poorer clinical outcomes.