GUILLAIN-BARRE SYNDROME- CLINICAL PRESENTATION, TREATMENT PATTERN AND OUTCOME
Author(s)
Vijayanarayana K1, Beena AS1, Anuvrinda C1, Bhumika M1, Sreedharan N1, Shivashankar KN2
1Dept. of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, Karnataka State., India, 2Dept. of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka State., India
OBJECTIVES: To study the clinical presentations, treatment pattern and outcome of patients diagnosed with Guillain-Barre Syndrome (GBS). METHODS: A retrospective observational study, carried out in a tertiary care teaching hospital. Data of patients diagnosed with GBS and admitted to ICUs, medical wards and neurological wards from 2008 to 2013, was collected from medical records department (MRD) registry using ICD-10 code G61.0 RESULTS: During the study period total 130 patients were diagnosed with GBS. The mean age of the study population was 35.3±20.7 years (mean±SD) and 55.4% (n=72) patients were male. Hospital admissions due to GBS showed a marked escalation yearly from 2008 to 2013. 48.4% (n=63) of patients reported flu like syndrome along with loose stools one week prior to GBS onset. The main clinical manifestations of GBS, bilateral ascending weakness and areflexia was seen in 69.2% of patients. Respiratory paralysis is the major cause of mortality in GBS patients and was present in 17.7% (n=23) of the patients. Among the study population 49.2% (n=64) of patients received intravenous Ig (IVIg) therapy and 11.5% (n=15) of patients underwent plasmapheresis. Other supportive therapies included were physiotherapy/occupational therapy (13.8%) and corticosteroid therapy (10.8%). Due to high economic burden 14.6% (n=19) of patients denied all treatments. Among the patients who received IVIg therapy, 4.7% showed complete recovery and 82.8% showed significant improvement whereas patients who received plasmapheresis, 85.7% showed significant improvement. The mortality rate in patients who received IVIg was 1.6% whereas in plasmapheresis was 7.1%. CONCLUSIONS: Both IVIg and plasmapheresis treatments showed significant improvement within 3 weeks. In our study setting, IVIg was the preferred treatment option due to low side effect profile and ease of administration however cost of treatment is higher compared to plasmapheresis. Plasmapheresis was associated with complications such as BP, HR fluctuations.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PSY7
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Systemic Disorders/Conditions