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Journal of Neurology

, Volume 260, Issue 5, pp 1367–1374 | Cite as

Long-term outcome in patients with Guillain–Barré syndrome requiring mechanical ventilation

  • J. WitschEmail author
  • N. Galldiks
  • A. Bender
  • R. Kollmar
  • J. Bösel
  • C. Hobohm
  • A. Günther
  • I. Schirotzek
  • K. Fuchs
  • E. Jüttler
Original Communication

Abstract

We aimed to determine long-term disability and quality of life in patients with Guillain–Barré syndrome (GBS) who required mechanical ventilation (MV) in the acute phase. Our retrospective cohort study included 110 GBS patients admitted to an intensive care unit and requiring MV (01/1999–08/2010) in nine German tertiary academic medical centers. Outcome was determined 1 year or longer after hospital admission using the GBS disability scale, Barthel index (BI), EuroQuol-5D (EQ-5D) and Fatigue Severity Scale. Linear/multivariate regression analysis was used to analyze predicting factors for outcome. Mean time to follow up was 52.6 months. Hospital mortality was 5.5 % and long-term mortality 13.6 %. Overall 53.8 % had a favorable outcome (GBS disability score 0–1) and 73.7 % of survivors had no or mild disability (BI 90–100). In the five dimensions of the EQ-5D “mobility”, “self-care”, “usual activities”, “pain” and “anxiety/depression” no impairments were stated by 50.6, 58.4, 36.4, 36.4 and 50.6 % of patients, respectively. A severe fatigue syndrome was present in 30.4 % of patients. Outcome was statistically significantly correlated with age, type of therapy and number of immunoglobulin courses. In GBS-patients requiring MV in the acute phase in-hospital, and long-term mortality are lower than that in previous studies, while long-term quality of life is compromised in a large fraction of patients, foremost by immobility and chronic pain. Efforts towards improved treatment approaches should address autonomic dysfunction to further reduce hospital mortality while improved rehabilitation concepts might ameliorate long-term disability.

Keywords

Guillain–Barré syndrome Peripheral neuropathy Critical care Outcome research Mortality Quality of life 

Notes

Acknowledgments

The authors wish to thank Miriam Bauer and Dominik Diesing (both Charité Center for Stroke Research Berlin) for technical support, Olivia Rudnicki (University of Erlangen) for data acquisition and Catherine Aubel (Charité Center for Stroke Research Berlin) for language editing of the final manuscript.

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standard

This study has been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in 1964 Declaration of Helsinki.

Supplementary material

415_2012_6806_MOESM1_ESM.pdf (73 kb)
Supplementary material 1 (PDF 73 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • J. Witsch
    • 1
    • 2
    Email author
  • N. Galldiks
    • 3
    • 4
  • A. Bender
    • 5
    • 6
  • R. Kollmar
    • 7
  • J. Bösel
    • 8
  • C. Hobohm
    • 9
  • A. Günther
    • 10
  • I. Schirotzek
    • 11
  • K. Fuchs
    • 12
  • E. Jüttler
    • 1
    • 13
  1. 1.Center for Stroke Research Berlin (CSB)Charité University Medicine BerlinBerlinGermany
  2. 2.Department of NeurologyCharité University MedicineBerlinGermany
  3. 3.Department of NeurologyUniversity of CologneCologneGermany
  4. 4.Institute of Neuroscience and MedicineForschungszentrum JülichJuelichGermany
  5. 5.Department of NeurologyLudwig-Maximilians-UniversityMunichGermany
  6. 6.Department of NeurologyTherapiezentrum BurgauBurgauGermany
  7. 7.Department of NeurologyFriedrich-Alexander-University ErlangenErlangenGermany
  8. 8.Department of NeurologyUniversity of HeidelbergHeidelbergGermany
  9. 9.Department of NeurologyUniversity of LeipzigLeipzigGermany
  10. 10.Department of NeurologyUniversity of JenaJenaGermany
  11. 11.Department of NeurologyUniversity of GiessenGiessenGermany
  12. 12.Department of AnesthesiologyUniversity of RegensburgRegensburgGermany
  13. 13.Department of NeurologyRehabilitation and University Hospitals UlmUlmGermany

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