Background
Methods
Study subjects
Measurement of disability
The clinic GBS severity evaluation scale (CGSES)
Statistics
Results
Chief complaints are composed of seven elements
Basic information | |
---|---|
Male/female ratio | 311/212 |
Age (years), median (IQR) | 36 (26–45) |
Duration in hospital (days), median (IQR) | 15 (10–20) |
Symptoms of antecedent infection (n = 523) | |
Interval between infection and onset (days), median (IQR) | 5 (2–9) |
Diarrhea, No. (%) | 137 (26.20) |
Upper respiratory tract infection, No. (%) | 153 (29.25) |
Severity of disease (n = 523) | |
MRC sum score at admission, median (IQR) | 48 (42–56) |
HFGS at admission, median (IQR) | 3 (2–4) |
MRC sum score at nadir, median(IQR) | 48 (36–54) |
HFGS at nadir, median (IQR) | 3 (2–4) |
Interval between onset and nadir (days), median (IQR) | 8 (6–12) |
MRC sum score at discharge, median (IQR) | 56 (49–60) |
HFGS at discharge, median(IQR) | 2 (1–3) |
Clinical manifestations (n = 523) | |
Cranial nerve involvement, No. (%) | 236 (45.12) |
Hyporeflexia/areflexia, No. (%) | 484 (92.54) |
Superficial sensation deficits, No. (%) | 223 (43.05) |
Autonomic deficits, No. (%) | 289 (55.26) |
Dyspnea, No. (%) | 134 (25.62) |
Ventilator dependence, No. (%) | 64 (12.24) |
Blood routine examination at admission (n = 523) | |
White blood cell, mean (SD), 109/L | 9.00 (3.61) |
Neutrophil, mean (SD), % | 68.75 (3.63) |
Lymphocyte, mean (SD), % | 23.36 (0.10) |
Lumbar puncture (n = 287) | |
Protein concentration, mean (SD), g/L | 1.05 (0.88) |
White blood cell, mean (SD), 106/L | 3 (2–7) |
Albumin-cytologic dissociations, No. (%) | 192 (66.90) |
IgG concentration, mean (SD), mg/L | 189.24 (205.63) |
Nerve conduction studies (n = 165) | |
Demyelinating group, No. (%) | 89 (53.94) |
Axonal group, No. (%) | 46 (27.88) |
Overlap group, No. (%) | 30 (18.18) |
Chief complaint | Number of patients | Details, No. (%) |
---|---|---|
Weakness | 384 | Four limbs 294 (76.56), lower extremities 47 (12.24), upper extremities 20 (5.21), hands and feet 2 (0.52), hands 4 (1.04), asymmetric weakness 17 (4.43) |
Numbness | 161 | Four limbs 100 (62.11), lower extremities 12 (7.45), upper extremities 6 (3.73), hands and feet 14 (8.70), hands 6 (3.73), feet 2 (1.24), fingers 4 (2.48), toes 1 (0.62), fingers and toes 1 (0.62), face 1 (0.62), whole body 1 (0.62), tongue 1 (0.62), tongue and face 1 (0.62), asymmetric numbness 1 (0.62) |
Pain | 19 | Details were missing. |
Cranial nerve involvement | 73 | Oculomotor and/or abducent nerve 25 (34), facial nerve 17 (23), glossopharyngeal and vagus nerve 35 (48), trigeminal nerve 2 (3) |
Dyspnea | 10 | |
Ataxia | 2 | |
Autonomic dysfunction (including pain) | 23 | Pain 19 (83), palpitation 1 (4), urinary retention 1 (4), sweating 1 (4), swelling on hands 1 (4). |
Doctors find more than patients report
Chief complaints aid prediction of disease severity and clinical manifestations
Complaint with/without weakness | Complaint with/without numbness | |||||
---|---|---|---|---|---|---|
with | Without |
P value | with | without |
P value | |
Basic information | ||||||
Number of patient | 384 | 139 | 161 | 362 | ||
Male/female ratio | 234/150 | 77/62 | .23 | 90/71 | 222/140 | .23 |
Age, median (IQR) | 39 (29–48) | 47 (34.25–58.75) | .042 | 41 (31–56) | 40 (29.5–50) | .30 |
Antecedent infection | ||||||
Diarrhea, No. (%) | 111 (28.80) | 27 (19.59) | .031 | 36 (22.64) | 100 (27.75) | .21 |
Upper respiratory tract infection, No. (%) | 103 (26.93) | 49 (35.14) | .063 | 64 (39.62) | 90 (24.73) | .001 |
Clinical manifestations | ||||||
Cranial nerve involvement, No. (%) | 152 (39.49) | 79 (56.72) | < .001 | 82 (50.76) | 157 (43.26) | < .001 |
Hyporeflexia, No. (%) | 361 (94.03) | 119 (85.96) | .002 | 99 (61.24) | 134 (37.02) | < .001 |
Sensory deficits, No. (%) | 160 (41.67) | 65 (46.58) | .34 | 94 (58.22) | 132 (36.39) | < .001 |
Autonomic deficits, No. (%) | 200 (52.00) | 88 (63.51) | .017 | 97 (60.38) | 192 (53.02) | .14 |
Dyspnea, No. (%) | 101 (26.40) | 33 (23.65) | .16 | 32 (20.13) | 101 (28.02) | .053 |
Ventilator dependence, No. (%) | 46 (12.00) | 18 (12.84) | .79 | 14 (8.81) | 46 (12.74) | .11 |
Severity of disease | ||||||
MRC sum score at admission, median (IQR) | 45 (32.75–52) | 47 (37.5–56) | < .001 | 48 (42–56) | 42.5 (31.25–51.5) | < .001 |
HFGS at admission, median (IQR) | 4 (2.75–4) | 3 (1.75–4) | < .001 | 3 (2–4) | 4 (2–4) | < .001 |
MRC sum score at nadir, median (IQR) | 42 (28–48.25) | 42 (34–54.5) | < .001 | 46 (36–54) | 36 (21–48) | < .001 |
HFGS at nadir, median (IQR) | 4 (3–4) | 3.5 (2–4) | .001 | 3 (3–4) | 4 (3–4) | < .001 |
MRC sum score at discharge, median (IQR) | 54 (44–57.25) | 54 (42–60) | .002 | 55 (48–60) | 48.5 (36.5–58) | < .001 |
HFGS as discharge, median (IQR) | 2 (2–4) | 1 (0–1.25) | .002 | 2 (1–3.75) | 3 (1–4) | .009 |
Chief complaints are predictors for prognosis
Establishment of CGSES
Predictors | Score | ||||||
---|---|---|---|---|---|---|---|
A. | |||||||
Chief complain of weakness | |||||||
with | 1 | ||||||
without | 0 | ||||||
Chief complain of numbness | |||||||
with | −1 | ||||||
without | 0 | ||||||
Chief complain associated with cranial nerve involvement | |||||||
with | −1 | ||||||
without | 0 | ||||||
Duration between onset and admission (days) | |||||||
0–2 | 3 | ||||||
3–5 | 2 | ||||||
6–10 | 1 | ||||||
> 10 | 0 | ||||||
sum of score | −2 to 4 | ||||||
B. | |||||||
sum of score | −2 | −1 | 0 | 1 | 2 | 3 | 4 |
CGSES | 1 | 1 | 2 | 2 | 3 | 4 | 4 |