Erasmus Guillain-Barre Syndrome Outcome Score (EGOS) to predict functional outcomes

-

  • Maria Ulfa GadjahMada University
  • Titis Widowati GadjahMada University
  • Agung Triono
Keywords: EGOS; Guillain-Barre syndrome; functional outcomes

Abstract

 

Background Guillain-Barre syndrome (GBS) has a highly diverse clinical course and prognosis. Predicting functional  outcomes  is needed in order to give appropriate treatment and counseling. Erasmus Guillaine-Barre Syndrome Outcome Score (EGOS) is simple scoring based on age onset, pre existing diarhea and GDS score obtained from  medical record and physical findings that can be used by clinician to predict the functional outcomes  of the child with GBS..

Objective To assess the usefulness of EGOS to predict functional  outcomes  of GBS patients.

Methods A retrospective cohort study to see the functional outcomes which is walking or not walking of children with GBS aged 6 months to 18 years hospitalized in RSUP Dr. Sardjito, Yogyakarta from 2014 to 2019 were enrolled by a purposive sampling method. Bivariate and logistic regression multivariate backward method analyses were used to assess for possible correlations between predictive factors and functional  outcomes  in GBS patients.

Results A total of 33 patients were enrolled and analyzed. After six months of weakness, 57.1% of patients with high EGOS (> 4) had poor functional  outcomes  according to the Hughes scale, scoring to asses functional  outcomes . Patient with high EGOS (> 4) had greater risk of poor functional  outcomes  compared to patients with lower EGOS (≤ 4) (P=0.006; OR 33.3; 95%CI 2.74 to 404.94). Poor functional  outcomes  of GBS patients was not influenced by preceding upper respiratory tract infection, cranial nerve involvement, use of ventilator, autonomic dysfunction, immunotherapy, complicating disease, rehabilitation, or nutritional status.

Conclusion High EGOS of >4 is a predictor for poor functional  outcomes  in children with GBS.

References

1. van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol. 2008;7(10):939–50. DOI :10.1016/S1474-4422(08)70215-1.
2. Tan C, Razali SNO, Nortina KG. The utility of Guillain-Barré syndrome prognostic models in Malaysian patients. 2019;(April):168–73. DOI : 10.1111/jns.12320.
3. Dourado Júnior MET, Fernandes UT, Ramos ES, Vital ALF, Urbano JCC, Queiroz JW, et al. Egos has a reduced capacity to predicts GBS prognosis in Northeast Brazil. Acta Neurol Scand. 2018;138(5):459–62. DOI : 10.1111/ane.12995 .
4. Asbury AK. Diagnostic Considerations in Gdain-Bar6 Syndrome. 1980;1–5. DOI: 10.1002/ana.410090703.
5. Walgaard C. Early recognition of poor prognosis in syndrome. 2011;Neurology 2011;76;968 DOI: 10.1212/WNL.0b013e3182104407
6. González-suárez I, Sanz-gallego I, Javier F, Rivera R De, Arpa J. Guillain-Barré Syndrome?: Natural history and prognostic factors?: a retrospective review of 106 cases. 2013;2–7.
7. Draak THP, Gorson KC, Vanhoutte EK, van Nes SI, van Doorn PA, Cornblath DR, et al. Does ability to walk reflect general functionality in inflammatory neuropathies? J Peripher Nerv Syst. 2016;21:74–81. DOI : 10.1111/jns.12167.
8. Koningsveld R Van, Steyerberg EW, Hughes RAC, Swan A V, Doorn PA Van, Jacobs BC. Articles A clinical prognostic scoring system for Guillain-Barré syndrome. 2000;589–94. DOI : 10.1016/S1474-4422(07)70130-8.
9. Doorn PA Van. Diagnosis, treatment and prognosis of Guillain-Barré syndrome (GBS). Presse Med [Internet]. 2013;42(6):e193–201. DOI: 10.1016/j.lpm.2013.02.328
10. Kumar M, Aroor S, Mundkur S, Kumar S. Guillain-Barré syndrome: A clinical study of twenty children. J Clin Diagnostic Res. 2015;9(1):SC09-SC12. DOI : 10.7860/JCDR/2015/8344.5491.
11. Markovitz BP, Goodman DM, Watson RS, Bertoch D, Zimmerman J. A retrospective cohort study of prognostic factors associated with outcome in pediatric severe sepsis: What is the role of steroids? Pediatr Crit Care Med. 2005;6(3):270–4. DOI : 10.1097/01.PCC.0000160596.31238.72.
12. Mitsui Y, Kusunoki S, Arimura K, Kaji R, Kanda T, Kuwabara S, et al. A multicentre prospective study of Guillain-Barré Syndrome in Japan: A focus on the incidence of subtypes. J Neurol Neurosurg Psychiatry. 2015;86(1):110–4. DOI : 10.1136/jnnp-2013-306509.
13. Dias-Tosta E, Kückelhaus CS. Guillain barré syndrome in a population less than 15 years old in Brazil. Arq Neuropsiquiatr. 2002;60(2 B):367–73. DOI : 10.1590/S0004-282X2002000300005.
14. Akbayram S, Do M, Akgün C, Peker E, Say R, Aktar F, et al. Clinical features and prognosis with Guillain-Barré syndrome. 2011;14(2). DOI : 10.4103/0972-2327.82793
15. Sung EJ, Kim DY, Chang MC, Ko EJ. Prediction of functional outcome in axonal guillain-barre syndrome. Ann Rehabil Med. 2016;40(3):481–8. DOI : 10.5535/arm.2016.40.3.481.
16. Wang Y, Lang W, Zhang Y, Ma X, Zhou C, Zhang HL. Long-term prognosis of Guillain-Barré syndrome not determined by treatment options? Oncotarget. 2017;8(45):79991–80001. DOI : 10.18632/oncotarget.20620.
17. Barzegar M, Toopchizadeh V, Maher MHK, Sadeghi P, Jahanjoo F, Pishgahi A. Predictive factors for achieving independent walking in children with Guillain-Barre syndrome. Pediatr Res [Internet]. 2017;82(2):333–9. Tersedia pada: http://dx.doi.org/10.1038/pr.2017.67. DOI : http://dx.doi.org/10.1038/pr.2017.67.
18. Rajabally YA, Uncini A. Outcome and its predictors in Guillaine-Barré syndrome. J Neurol Neurosurg Psychiatry. 2012;83(7):711–8. DOI : 10.1136/jnnp-2011-301882.
19. Verboon C, Van Doorn PA, Jacobs BC. Treatment dilemmas in Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 2017;88(4):346–52. DOI : 10.1136/jnnp-2016-314862.
20. Albiol-Pérez S, Forcano-García M, Muñoz-Tomás MT, Manzano-Fernández P, Solsona-Hernández S, Mashat MA, et al. A novel virtual motor rehabilitation system for guillain-barré syndrome: Two single case studies. Methods Inf Med. 2015;54(2):127–34. DOI : 10.3414/ME14-02-0002.
Published
2022-04-12
How to Cite
1.
Ulfa M, Widowati T, Triono A. Erasmus Guillain-Barre Syndrome Outcome Score (EGOS) to predict functional outcomes. PI [Internet]. 12Apr.2022 [cited 26Apr.2024];62(2):130-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2589
Section
Pediatric Neurology
Received 2021-01-16
Accepted 2022-04-12
Published 2022-04-12