Peerada Chaweekulrat1, Oranee Sanmaneechai2,3. 1. Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 2. Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. oranee141@gmail.com. 3. Center of Excellence for Neuromuscular Diseases, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. oranee141@gmail.com.
Abstract
BACKGROUND: Guillain-Barré Syndrome (GBS) is an immune-mediated peripheral neuropathy. Clinical features and outcomes in children differ from adults. Currently, there is no prognostic model to predict outcomes in children and existing models for adults are not suitable. OBJECTIVES: To identify factors that are associated with outcomes and develop clinical model to predict time to independent walking in children with GBS. METHODS: Between 2005 and 2018, 41 patients with GBS were identified by retrospective chart review. Factors associated with independent walking were analyzed with the Kaplan-Meier method. A prediction model was developed based on regression coefficients from Cox's proportional hazard model. RESULTS: The disability score at maximum weakness and nerve conduction study results were associated with independent walking and included in the model. Scores range from 0 to 5. A score of 5 predicts 34 days to independent walking while a score of 0 predicts 5 months (mean 158 days, p = 0.008). CONCLUSION: This scoring system for pediatric patients provides predicts the time needed to achieve independent walking, an important milestone of recovery for communication with parents, and to assist clinicians to optimize treatment. Further studies of predictive factors and external validation are needed to improve precision of the model. IMPACT: This is the first study to create a prognostic scoring system for individual outcomes in children with GBS. A clinical prognostic model can predict time to achieve independent walking in individual pediatric patients with GBS. This model can assist clinicians to optimize treatment and guide decisions on rehabilitation to prevent long-term disability.
BACKGROUND: Guillain-Barré Syndrome (GBS) is an immune-mediated peripheral neuropathy. Clinical features and outcomes in children differ from adults. Currently, there is no prognostic model to predict outcomes in children and existing models for adults are not suitable. OBJECTIVES: To identify factors that are associated with outcomes and develop clinical model to predict time to independent walking in children with GBS. METHODS: Between 2005 and 2018, 41 patients with GBS were identified by retrospective chart review. Factors associated with independent walking were analyzed with the Kaplan-Meier method. A prediction model was developed based on regression coefficients from Cox's proportional hazard model. RESULTS: The disability score at maximum weakness and nerve conduction study results were associated with independent walking and included in the model. Scores range from 0 to 5. A score of 5 predicts 34 days to independent walking while a score of 0 predicts 5 months (mean 158 days, p = 0.008). CONCLUSION: This scoring system for pediatric patients provides predicts the time needed to achieve independent walking, an important milestone of recovery for communication with parents, and to assist clinicians to optimize treatment. Further studies of predictive factors and external validation are needed to improve precision of the model. IMPACT: This is the first study to create a prognostic scoring system for individual outcomes in children with GBS. A clinical prognostic model can predict time to achieve independent walking in individual pediatric patients with GBS. This model can assist clinicians to optimize treatment and guide decisions on rehabilitation to prevent long-term disability.