Clinical Progression and Determinants of Unfavorable Functional Outcomes in Guillain-Barré Syndrome – A Retrospective Analysis

Open Access

Abstract

Background: Guillain–Barré Syndrome (GBS) is an acute immune-mediated neuropathy causing motor, sensory, and autonomic dysfunction, often leading to long-term disability. Despite standard treatments, some patients experience rapid progression and unfavorable functional outcomes. Identifying predictors of poor recovery is crucial for early intervention and prognosis. Aim of the study: To evaluate the clinical progression of GBS and determine the factors associated with unfavorable short-term functional outcomes. Methods & Materials: A retrospective observational study was conducted at Dhaka Medical College Hospital from January 2017 to December 2018, including 50 adult patients with first-episode GBS admitted within seven days of symptom onset. Demographic, clinical, and laboratory data were collected. Functional outcomes at six weeks were assessed using the GBS Disability Scale. Univariate and multivariate analyses were performed to identify predictors of poor outcome. Result: Among 50 patients, 42 (84%) had favorable outcomes, and 8 (16%) experienced poor functional recovery. Advanced age (≥50 years), severe motor weakness (MRC score ≤10), pain at onset, hyponatremia (<135 mmol/L), and ICU admission were independent predictors of unfavorable outcomes. Significant correlations were observed between MRC sum score, CSF protein, serum sodium, and GBS disability scores. Conclusion: Advanced age, severe initial motor weakness, pain at onset, hyponatremia, and ICU admission are key determinants of poor short-term functional outcomes in GBS. Early identification of these high-risk patients may guide intensive monitoring, targeted therapy, and rehabilitation strategies to improve recovery.