BACKGROUND: Guillain-Barré syndrome (GBS) has a highly diverse clinical course and outcome, yet patients are treated with a standard therapy. Patients with poor prognosis may benefit from additional treatment, provided they can be identified early, when nerve degeneration is potentially reversible and treatment is most effective. We developed a clinical prognostic model for early prediction of outcome in GBS, applicable for clinical practice and future therapeutic trials. METHODS: Data collected prospectively from a derivation cohort of 397 patients with GBS were used to identify risk factors of being unable to walk at 4 weeks, 3 months, and 6 months. Potential predictors of poor outcome (unable to walk unaided) were considered in univariable and multivariable logistic regression models. The clinical model was based on the multivariable logistic regression coefficients of selected predictors and externally validated in an independent cohort of 158 patients with GBS. RESULTS: High age, preceding diarrhea, and low Medical Research Council sumscore at hospital admission and at 1 week were independently associated with being unable to walk at 4 weeks, 3 months, and 6 months (all p 0.05-0.001). The model can be used at hospital admission and at day 7 of admission, the latter having a better predictive ability for the 3 endpoints; the area under the receiver operating characteristic curve (AUC) is 0.84-0.87 and at admission the AUC is 0.73-0.77. The model proved to be valid in the validation cohort. CONCLUSIONS: A clinical prediction model applicable early in the course of disease accurately predicts the first 6 months outcome in GBS.
RCT Entities:
BACKGROUND: Guillain-Barré syndrome (GBS) has a highly diverse clinical course and outcome, yet patients are treated with a standard therapy. Patients with poor prognosis may benefit from additional treatment, provided they can be identified early, when nerve degeneration is potentially reversible and treatment is most effective. We developed a clinical prognostic model for early prediction of outcome in GBS, applicable for clinical practice and future therapeutic trials. METHODS: Data collected prospectively from a derivation cohort of 397 patients with GBS were used to identify risk factors of being unable to walk at 4 weeks, 3 months, and 6 months. Potential predictors of poor outcome (unable to walk unaided) were considered in univariable and multivariable logistic regression models. The clinical model was based on the multivariable logistic regression coefficients of selected predictors and externally validated in an independent cohort of 158 patients with GBS. RESULTS: High age, preceding diarrhea, and low Medical Research Council sumscore at hospital admission and at 1 week were independently associated with being unable to walk at 4 weeks, 3 months, and 6 months (all p 0.05-0.001). The model can be used at hospital admission and at day 7 of admission, the latter having a better predictive ability for the 3 endpoints; the area under the receiver operating characteristic curve (AUC) is 0.84-0.87 and at admission the AUC is 0.73-0.77. The model proved to be valid in the validation cohort. CONCLUSIONS: A clinical prediction model applicable early in the course of disease accurately predicts the first 6 months outcome in GBS.
Authors: R van Koningsveld; P I M Schmitz; F G Avander Meché; L H Visser; J Meulstee; P A van Doorn Journal: Lancet Date: 2004-01-17 Impact factor: 79.321
Authors: Cintya O Souza; Marcelo A C S Vieira; Francisca M A Batista; Kelsen D Eulálio; Jéssica M M Neves; Laís C Sá; Leni C R Monteiro; Walfrido S Almeida-Neto; Raimunda S S Azevedo; Dorcas L Costa; Ana C R Cruz Journal: Am J Trop Med Hyg Date: 2018-01-04 Impact factor: 2.345
Authors: Alex Y Doets; Hester F Lingsma; Christa Walgaard; Badrul Islam; Nowshin Papri; Amy Davidson; Yuko Yamagishi; Susumu Kusunoki; Mazen M Dimachkie; Waqar Waheed; Noah Kolb; Zhahirul Islam; Quazi Deen Mohammad; Thomas Harbo; Soren H Sindrup; Govindsinh Chavada; Hugh J Willison; Carlos Casasnovas; Kathleen Bateman; James A L Miller; Bianca van den Berg; Christine Verboon; Joyce Roodbol; Sonja E Leonhard; Luana Benedetti; Satoshi Kuwabara; Peter Van den Bergh; Soledad Monges; Girolama A Marfia; Nortina Shahrizaila; Giuliana Galassi; Yann Péréon; Jan Bürmann; Krista Kuitwaard; Ruud P Kleyweg; Cintia Marchesoni; María J Sedano Tous; Luis Querol; Isabel Illa; Yuzhong Wang; Eduardo Nobile-Orazio; Simon Rinaldi; Angelo Schenone; Julio Pardo; Frederique H Vermeij; Helmar C Lehmann; Volkan Granit; Guido Cavaletti; Gerardo Gutiérrez-Gutiérrez; Fabio A Barroso; Leo H Visser; Hans D Katzberg; Efthimios Dardiotis; Shahram Attarian; Anneke J van der Kooi; Filip Eftimov; Paul W Wirtz; Johnny P A Samijn; H Jacobus Gilhuis; Robert D M Hadden; James K L Holt; Kazim A Sheikh; Summer Karafiath; Michal Vytopil; Giovanni Antonini; Thomas E Feasby; Catharina G Faber; Cees J Gijsbers; Mark Busby; Rhys C Roberts; Nicholas J Silvestri; Raffaella Fazio; Gert W van Dijk; Marcel P J Garssen; Chiara S M Straathof; Kenneth C Gorson; Bart C Jacobs Journal: Neurology Date: 2021-12-22 Impact factor: 9.910