Predictors of Mechanical Ventilation Among 1960 Obese Patients Admitted With Guillain-Barré syndrome in the United States
Sailaja Sanikommu1, Shaheen Sombans2, Kamleshun Ramphul3, Renuka Verma4, Nomesh Kumar5, Yogeshwaree Ramphul6, Indu Meena3, Komal Kumari7, Stephanie Gonzalez Mejias3, Petras Jairam Das Lohana8, Fnu Arti9
1Independent Researcher & Sri Manakula Vinayagar Med College and Hosp, 2Bharati Vidyapeeth University Medical College and Hospital, Pune, India, 3Independent Researcher, 4Independent researcher, 5Detroit Medical Center, 6SSRN Hospital, 7LUMHS Jamshoro, 8Jacobi Medical Center, 9Medstar Union Memorial Hospital
Objective:
To understand the impact of obesity on the need for mechanical ventilation following admission for Guillain-Barré syndrome (GBS) and the associated risk of mortality.
Background:
Obesity is a fast-growing risk factor predisposing to many complications. Its impact on the outcomes of GBS patients has not been properly reported in the literature.
Design/Methods:
Obese patients with a principal diagnosis of GBS were pooled from the 2019 National Inpatient Sample. Logistic regression models, adjusting for confounders, were used to identify potential risk factors for requiring mechanical ventilation and overall mortality risk.
Results:
A total of 1960 obese patients with GBS were admitted in 2019, and 240 (12.2%) required mechanical ventilation. Arthropathies (aOR 4.876, 95% CI 2.582-9.206, p<0.01), chronic pulmonary disease (aOR 2.223, 95% CI 1.505- 3.283, p<0.01), acute kidney injury (aOR 6.068, 95% CI 4.047-9.097, p<0.01), ventricular tachycardia (aOR 3.401, 95% CI 1.353-8.549, p<0.01), and paroxysmal atrial fibrillation (aOR 8.176, 95% CI 4.608-14.505, p<0.01) were potential risk factors for requiring mechanical ventilation. Meanwhile hypothyroidism (aoR 0.370, 95% CI 0.216-0.634, p<0.01), diabetes (aOR 0.611, 95% CI 0.398-0.936, p=0.024), and patients covered by Medicaid (aOR 0.351, 95% CI 0.184-0.669, p<0.01), or private insurances (aOR 0.557, 0.351-0.883, p=0.013) (compared to Medicare) were at lower risk. Obese GBS patients using mechanical ventilation also had a higher risk of death (10.4% vs. 0.9%, aOR 47.586, 95% CI 12.334-169.823, p<0.01).
Conclusions:
Several factors influence the risk of requiring mechanical ventilation among obese GBS patients. Obese patients using mechanical ventilation were at risk of poorer outcomes.