New Combined Scoring System for Predicting Respiratory Failure in Iraqi Patients with Guillain-Barré Syndrome

Zaki Noah Hasan

Abstract


The Guillain-Barré syndrome (GBS) is an acute post-infective autoimmune polyradiculoneuropathy, it is the commonest peripheral neuropathy causing respiratory failure. The aim of the study is to use the New Combined Scoring System in anticipating respiratory failure in order to perform elective measures without waiting for emergency situations to occur.
Patients and methods: Fifty patients with GBS were studied. Eight clinical parameters (including progression of patients to maximum weakness, respiratory rate/minute, breath holding
count (the number of digits the patient can count in holding his breath), presence of facial muscle weakness (unilateral or bilateral), presence of weakness of the bulbar muscle, weakness of the neck flexor muscle, and limbs weakness) were assessed for each patient and a certain score was given to
each parameter, a designed combined score being constructed by taking into consideration all the above mentioned clinical parameters. Results and discussion: Fifteen patients (30%) that were enrolled in our study developed respiratory failure. There was a highly significant statistical association between the development of respiratory failure and the lower grades of (bulbar muscle weakness score, breath holding count scores, neck muscle weakness score, lower limbs and upper limbs weakness score , respiratory rate score) and the total sum score above 16 out of 30 (p-value=0.000) . No significant statistical difference was found regarding the progression to maximum weakness (p-value=0.675) and facial muscle weakness (p-value=0.482).
Conclusion: The patients who obtained a combined score (above 16’30) are at great risk of having respiratory failure.

Keywords


Guillain-Barre Syndrome, respiratory failure, scoring system

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