Clinical features and real-world outcomes of Guillain–Barré syndrome in the Philippines
Adrian Espiritu1, Karl Josef Niño Separa1, Francis Jordan Milla1, Karen Joy Adiao1, Carl Froilan Leochico1, Roland Dominic Jamora1
1University of the Philippines Manila
Objective:

We aimed to determine the profile of Guillain–Barré syndrome (GBS) in the Philippines, compare the outcomes who received intravenous immunoglobulin (IVIg) and therapeutic plasma exchange (TPE), and determine the factors related to prolonged hospital stay/late motor recovery.

Background:

There is a substantial deficiency of representative data in the literature on the profile and outcomes of GBS in the Philippines.

Design/Methods:

We conducted a retrospective cohort study of adult GBS patients admitted to the Philippine General Hospital from 2009 to 2019.

Results:

We included 105 patients with confirmed GBS diagnoses. The predominant variant was acute inflammatory demyelinating polyneuropathy (n = 40, 38.1%). The median time to onset of motor recovery was 13 days, while the median hospital stay was 15 days. The difference in outcomes of patients in the IVIg (n = 44) and TPE (n = 24) groups (walking with aid/GBS-disability scores/ventilator dependency at 1 month, duration dependent on the ventilator, intensive care unit stay, and hospital stay) were not statistically significant, except for mild disability at 1 month (p = 0.009). Pneumonia (crude odds ratio (OR) 7.85, 95% CI 2.89–21.33, p < 0.001; adjusted OR 5.65, 95% CI 1.59– 20.05, p = 0.007), urinary tract infection (crude OR 6.5, 95% CI 1.39–30.47, p = 0.008; adjusted OR 15.62, 95% CI 1.80–135.82, p = 0.013), and dysautonomia (crude OR 3.60, 95% CI 1.31–9.91, p = 0.01) were significantly related to a prolonged hospital stay. Considering only the treatment groups, the hazard ratio (HR) for late onset of motor recovery comparing IVIg and TPE was 0.75 (95% CI 0.31–1.85, p = 0.533) which was not not statistically significant; after adjusting for age and sex, the HR remained insignificant (0.69, 95% CI 0.27–1.74, p = 0.429).

Conclusions:

Our study presented the first comprehensive information regarding the features and outcomes of GBS patients in the Philippines.

10.1212/WNL.0000000000203087