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Multicenter Study
. 2023 May:44:18-24.
doi: 10.1016/j.ejpn.2023.02.007. Epub 2023 Mar 10.

Predicting respiratory failure and outcome in pediatric Guillain-Barré syndrome

Joyce Roodbol  1 , Rudolf Korinthenberg  2 , Esmee Venema  3 , Marie-Claire Y de Wit  4 , Hester F Lingsma  5 , Coriene E Catsman-Berrevoets  4 , Bart C Jacobs  6 ; Working Group GBS in Children in Germany; Austria and Switzerland and the Dutch Pediatric GBS Study Group
Collaborators, Affiliations
Free article
Multicenter Study

Predicting respiratory failure and outcome in pediatric Guillain-Barré syndrome

Joyce Roodbol et al. Eur J Paediatr Neurol. 2023 May.
Free article

Abstract

Background: Guillain-Barré syndrome (GBS) has a highly variable clinical course and outcome as indicated by the risk of developing respiratory failure and residual inability to walk. Prognostic models as Erasmus GBS Respiratory Insufficiency Score (EGRIS) developed in adult patients are inaccurate in children. Our aim was to determine the prognostic factors of respiratory failure and inability to walk in children with GBS and to develop a new clinical prognostic model for individual patients (EGRIS-Kids).

Methods: A multicenter retrospective cohort study was performed using the data of children (younger than 18 years) fulfilling the diagnostic criteria for GBS from the NINDS. This study was performed in two independent cohorts from centers in Germany, Switzerland, Austria (N = 265, collected 1989-2002) and The Netherlands (N = 156, collected 1987-2016). The predicted main outcomes were occurrence of respiratory failure during the disease course and inability to walk independent at one year after diagnosis.

Results: In the combined cohort of 421 children, 79 (19%) required mechanical ventilation and one patient died. The EGRIS-kids was developed including: age, cranial nerve involvement and GBS disability score at admission, resulting in a 9 point score predicting risks of respiratory failure ranging from 4 to 50% (AUC = 0.71). A lower GBS disability score at nadir was the strongest predictor of recovery to independent walking (at one month: OR 0.43 95%CI 0.25-0.74).

Conclusions: EGRIS-Kids and GBS disability score at admission accurately predict the risk of respiratory failure and inability to walk respectively in children with GBS, as tools to personalize the monitoring and treatment.

Keywords: Children; Guillain-Barré syndrome; Prognostic models and; Respiratory failure.

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Conflict of interest statement

Declaration of competing interest Drs. J. Roodbol has no disclosures to report. Prof. Dr. R Korinthenberg has no actual conflicts of interest to report. Drs E. Venema has no disclosures to report. Dr. M.C.Y. de Wit received honoraria paid to her institution by Novartis for serving on a steering committee and presenting at a conference, and has received research funding from the Epilepsiefonds (Dutch Epilepsy Foundation), Hersenstichting and Sophia Foundation. Dr. H. F. Lingsma has no disclosures to report. Dr. C.E. Catsman-Berrevoets has no disclosures to report. Dr. B.C. Jacobs has received funding for travel from Baxter International Inc, and has received research funding from the Netherlands Organization for Health Research and Development, Erasmus MC, Prinses Beatrix Spierfonds, Stichting Spieren voor Spieren, CSL-Behring, Grifols, Annexon, Hansa Biopharma and the GBS-CIDP Foundation International.

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