AI Article Synopsis

  • The study aimed to explore how liver function biomarkers could predict clinical outcomes in patients with Guillain-Barré syndrome (GBS), focusing on those who required mechanical ventilation (MV).
  • A total of 208 GBS patients were analyzed, revealing that indicators of liver function, like reduced total protein and albumin levels, were linked to an increased need for MV and poorer recovery post-treatment.
  • Results showed that patients with impaired liver function not only had a higher risk of requiring MV but also faced challenges in walking independently and had increased mortality rates after 26 weeks.

Article Abstract

Background And Aims: Little is known about the ability of serological biomarkers to monitor clinical outcomes in patients with Guillain-Barré syndrome (GBS). The objective of this study was to determine the associations of liver function, easily available and convenient biomarkers, with the clinical course and outcome of severe GBS in patients.

Methods: A prospective data collection was conducted in a cohort of 343 GBS patients from multi-centers between September 2019 and December 2023. Serum samples were obtained at four-time points for mechanical ventilation (MV) patients and two-time points for non-MV patients. The primary endpoint was the need for MV during hospitalization, while secondary outcomes included the ability to walk independently and the mortality at 26-week follow-up.

Results: (i) A total of 208 patients were eligible, of whom 50 required MV with a median (interquartile range) ventilation duration of 15 (8-27) days. (ii) Hypohepatia, as evidenced by reduced total protein (OR 0.913 [95% CI 0.862-0.967]) and albumin (0.775 [0.679-0.884]) 1 week after treatment, along with raised liver enzymes (2.732 [1.007-7.413]), was associated with the risk of MV after adjusting for confounders. (iii) After 26-week follow-up, patients with hypohepatia were less likely to regain independent walking and exhibited higher mortality in survival analysis (all log-rank p < .05). (iv) In a cross-sectional study spanning up to 4 years of follow-up, patients with prolonged MV (≥15 days) experienced a longer time to regain independent ambulation than those with shorter MV (167 [46-316] vs. 69 [24-106], p = .036). However, no relationships between liver function and prolonged MV were revealed.

Interpretation: Dynamically monitoring hepatic metabolism and promptly adjusting, it can aid the improvement of GBS in patients.

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Source
http://dx.doi.org/10.1111/jns.12661DOI Listing

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