Utility of prognostic models and early predictors of functional outcome in Guillain-Barré syndrome in an Indian cohort

Abstract

Objectives: The study aimed to evaluate the prognostic models modified Erasmus Guillain–Barré syndrome(GBS) outcome score (mEGOS) and Erasmus GBS respiratory insufficiency score (EGRIS) and to examine biochemical and hematological predictors of functional outcomes in an Indian GBS cohort.

Methods: An ambispective observational study was conducted in the neurology department of a tertiary care center in northwest India from 2021 to 2024 including 68 patients aged 18 and older, diagnosed with classical GBS per the Brighton criteria.

Results: Among the 68 patients (mean age 39.28 years), 63.2% were male, 95.6% presented within two weeks of illness onset, 25% had prodromal illnesses, and 35.3% had cranial nerve involvement. Nerve conduction studies revealed acute inflammatory demyelinating polyneuropathy, acute motor axonal neuropathy, and acute motor- sensory axonal neuropathy in 27.9%, 42.6%, and 2.9% of patients respectively. Mean(±SD) GBS disability scale (GDS) scores at admission, 1 month, and 6 months were 3.50 (±0.74), 1.79 (±1.26), and 0.84 (±1.00), respectively, mean(±SD) mEGOS and EGRIS scores at admission were 4.68 (±3.10) and 1.86 (±1.46), respectively. In 1.5% of patients, mechanical ventilation was needed, and 88.2% received intravenous immunoglobulin. The mEGOS score correlated significantly with the GDS at admission, 1 month, and 6 months. Significant correlations were found between neutrophil/lymphocyte ratio, lymphocyte percentage, and GDS score at admission. Platelet count correlated with GDS scores at 6 months (p < 0.05).

Conclusion: Prognostic models mEGOS and EGRIS, along with inflammatory biochemical markers, effectively assess disease severity, need for intensive care, and predict functional outcomes in the Indian GBS population.