Characteristics, incidence and outcome of patients admitted to intensive care unit with Guillain-Barre syndrome in Australia and New Zealand.

Abstract

To describe characteristics, incidence and outcome of patients with Guillain-Barre syndrome (GBS) admitted to ICU. We conducted a binational, retrospective, observational, epidemiological study. We compared the baseline characteristics, physiological conditions and outcomes for GBS patients with or without mechanical ventilation (MV) and of survivors and non-survivors. We studied 711 patients admitted to 173 ICUs between 2005 and 2015. We found an increasing proportion of GBS admissions per year (P < 0.03). 237 patients required MV. These patients had higher APACHE III scores (47 vs 31), worse PaO2/FiO2 ratio (P/F 258 v 341), a significantly longer ICU LOS (25 v 4 days) (P < 0.0001, all comparisons) and a greater incidence of pre-ICU cardio-respiratory arrest (6.7% v 1.2%). Similarly, non-survivors were 5-times more likely to have experienced a pre-ICU cardio-respiratory arrest. Overall, ICU and hospital mortality were 3.9% and 6.9%, respectively and increased to 9.7% and 14.3% in the MV group. MV patients remained in hospital for almost 40 days. GBS represents a small but increasing proportion of ICU admissions with one-third of patients receiving MV. Overall in-hospital mortality is relatively low but doubles if MV is needed. These observations provide important prognostic information to clinicians involved in the care of these patients.