Factores pronósticos en el síndrome de Guillain-Barré: un estudio prospectivo en el sur de Uruguay

Background and objective

Guillain-Barré Syndrome (GBS) is an immune-mediated disorder of the peripheral nervous system characterized by acute, symmetric muscle weakness. Understanding its regional epidemiology and prognostic factors is crucial for clinical management. This study analyzed the incidence and prognostic factors of GBS in Uruguay, focusing on identifying clinical variables associated with poor outcomes and the need for mechanical ventilation (MV).

Methods

A prospective study was conducted on 61 GBS patients over two years in Uruguay. Data collected included demographic and clinical characteristics, cerebrospinal fluid (CSF) protein levels, and serological tests. The primary outcome was to predict the need for MV. The secondary outcome was functional recovery at 6 months, assessed with the Hughes scale. Bivariate analysis was used to evaluate associations between clinical variables, MV requirement, and outcomes.

Results

Among the 61 cases, 38 (62%) were men, with a median age of 56 years. Autonomic dysfunction was observed in 39% of patients. Eighteen (29%) required MV, which was significantly associated with autonomic dysfunction, bulbar weakness, and the Medical Research Council (MRC) sum score. The MRC score and the Erasmus GBS Outcome Scale (mEGOS) at day 7 were related to worse recovery at 6 months. No significant associations were found between CSF protein levels and outcomes. Campylobacter infection was low (10%).

Conclusions

Regional variations in the epidemiology and prognostic factors of GBS necessitate tailored clinical management. Autonomic dysfunction and bulbar weakness are critical for predicting the need for MV. The MRC score provides a simple tool for prediction in the clinical setting. This study enhances the understanding of GBS and guides clinical decision-making in Uruguay and similar regions.