GUİLLAİN-BARRE SENDROMLU HASTALARDA KLİNİK SEYİR VE PROGNOZ İLE İLİŞKİLİ FAKTÖRLERİN DEĞERLENDİRİLMESİ

Öz

Amaç: Guillain-Barré sendromunda (GBS) kötü prognozla ilişkili öngörücü faktörleri belirlemek, hastalığın seyrinde etkin tedaviyi erken dönemde sağlamak önemlidir. Bu çalışmada amaç; GBS tanılı hastaların klinik, labaratuvar, elektrofizyolojik ve demografik özelliklerini saptamak ve taburculuk esnasındaki prognoz üzerine katkısı olan faktörleri belirlemektir. Gereç ve Yöntem: Çalışmaya 2013 Ocak ve 2017 Aralık tarihleri arasında kliniğimizde yatırılarak tedavisi yürütülen 138 hasta dahil edildi. Hasta kayıtları retrospektif olarak incelendi. Hastaların yatış ve taburculuk esnasındaki Hughes skorları, demografik özellikleri, klinik ve labaratuvar verileri kaydedildi. Bulgular: Hastaların 61’i kadın (%44,2), 77’si erkek (%55,8)’ti. Yaş ortalamaları 58,119,7 yıl idi. Hastaların yatış muayenelerinde Hughes skorları ve taburculuk muayenelerinde Hughes skorları değerlendirildi. Buna göre taburculuk esnasında 112 hasta iyi prognozlu, 20 hasta kötü prognozlu olarak kabul edildi. Prognoz üzerine etkili olan faktörler ileri yaş, yüksek WBC sayısı, sepsis, hastane yatış süresinin fazla olması, yatış esnasında yüksek Hughes skoru olması ve mekanik ventilatör ihtiyacı olarak belirlendi Sonuçlar: En sık görülen GBS alt tipi akut enflamatuvar demiyelinizan polinöropatiydi. Taburculuk prognozları açısından kötü prognostik faktörler; MV ihtiyacı, yatış gün sayısının fazla olması, yatış esnasında kötü motor fonksiyon, yüksek WBC sayısı, sepsis ve ileri yaştır.

Anahtar Kelimeler

• Guillain-Barre sendromu
• prognostik faktörler
• klinik seyir

Evaluation of Factors Associated with the Clinical Course and Prognosis of Patients with Guillain-Barre Syndrome

Abstract

Aim: This study aims to investigate the clinical, laboratory, electrophysiological, and demographic characteristics of patients with Guillain-Barre Syndrome (GBS) who were admitted to our clinic and underwent treatment and the factors contributing to the prognosis at discharge.
Materials and Methods: The study included 138 patients admitted to our clinic for treatment between January 2013 and December 2017, whose patient records were reviewed retrospectively. The Hughes scores, demographic characteristics, and clinical and laboratory data of the patients at admission and discharge were recorded.
Results: The study sample comprised 61 female (44.2%) and 77 male (55.8%) patients with a mean age of 58.1 years. In evaluations of the Hughes scores at admission and discharge, 117 patients were considered to have a good prognosis and 21 patients to have a poor prognosis at discharge. In the poor prognosis group, advanced age (p=0.028), being in the acute motor axonal neuropathy (AMAN) subtype (p=0.001), development of sepsis (p=0.007), need for mechanical ventilation (p<0.001), high Hughes scores on admission (p<0.001), extended hospitalization (p=0.030), increased WBC count (p=0.033), presence of hyponatremia (p<0.001), abnormal liver function test (p=0.08) were higher than the good prognosis group.
Conclusion: Early identification of GBS patients who may have a poor prognosis and rapid application of appropriate treatment methods are essential in creating positive effects on the clinical course and prognosis in this patient group.

Keywords

• Guillain-Barré syndrome
• prognostic factors
• clinical course

Kaynakça

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