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Predicting Mechanical Ventilation Using the EGRIS in Guillain–Barré Syndrome in a Latin American Country

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A Correction to this article was published on 20 July 2021

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Abstract

Background

Up to one fifth of patients with Guillain–Barré syndrome (GBS) require mechanical ventilation (MV). The Erasmus GBS Respiratory Insufficiency Score (EGRIS) is a clinical predictive model developed in Europe to predict MV requirements among patients with GBS. However, there are significant differences between the Latin American and European population, especially in the distribution of GBS subtypes. Therefore, determining if the EGRIS is able to predict MV in a Latin American population is of clinical significance.

Methods

We retrospectively analyzed clinical and laboratory data of 177 patients with GBS in three Peruvian hospitals. We performed a multivariate logistic regression of the factors making up the EGRIS. Finally, we evaluated the EGRIS discrimination through a receiver operating characteristic curve and determined its calibration through a calibration curve and a Hosmer–Lemeshow test, a test used to determine the goodness of fit.

Results

We found that 14.1% of our patients required MV. One predictive factor of a patient’s need for early MV was the number of days between the onset of motor symptoms and hospitalization. The Medical Research Council sum score did not alter the likelihood of early MV. Bulbar weakness increased the likelihood without showing statistical significance. In contrast, facial weakness was a protective factor of it. The EGRIS was significantly higher in patients who required early MV than in those who did not (P = 0.018). It showed an area under the curve (AUC) of 0.63, with an insignificant Hosmer–Lemeshow test result.

Conclusions

Although the EGRIS was higher in patients who required early MV than in those who did not, it only showed a moderate discrimination capacity (AUC = 0.63). Facial weakness, an item of the EGRIS, was not found to be a predictive factor in our population. We suggest assessing whether these findings are due to subtype predominance and whether a modified version of the EGRIS could improve performance.

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Acknowledgments

We thank Dr. Victor Velasquez, from Red de Eficacia Clínica y Sanitaria, for his review of the manuscript.

Funding

This study was self-funded.

Author information

Authors and Affiliations

  1. Grupo Estudiantil de Investigación en Neurociencias, Universidad de San Martin de Porres, Lima, Peru

    Marco Malaga, Aaron Rodriguez-Calienes, Adrian Marquez-Nakamatsu, Katherine Recuay, Luis Merzthal & Diego Bustamante-Paytan

  2. Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Peru

    Marco Malaga, Aaron Rodriguez-Calienes, Adrian Marquez-Nakamatsu, Katherine Recuay, Luis Merzthal, Diego Bustamante-Paytan, Juan Manuel Sifuentes & Guillermo Castillo-Kohatsu

  3. Centro de Investigación Básica en Enfermedades Neuromusculares y de Motoneurona, Instituto Nacional de Ciencias Neurológicas, Lima, Peru

    Juan Manuel Sifuentes

  4. Servicio de Neurología, Hospital Nacional Arzobispo Loayza, Lima, Peru

    Guillermo Castillo-Kohatsu

  5. Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru

    Carlos Alva-Diaz

  6. Servicio de Neurología, Departamento de Medicina, Hospital Daniel Alcides Carrión, Callao, Peru

    Carlos Alva-Diaz

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  1. Marco Malaga
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Contributions

Authorship requirements have been met, and all authors approved the final manuscript. Contributions are as follows: MM: Conceptualization, Methodology, Analysis, Data collection, Data curation, Writing - Original Draft, Writing - Review & Editing, Supervision; ARC: Methodology, Data collection, Data curation, Writing - Original Draft, Writing - Review & Editing, Supervision; AMN, KR, LM, DBP: Data collection, Data curation, Writing - Original Draft; JMS, GCK: Writing - Review & Editing, Supervision; CAD: Methodology, Analysis, Writing - Review & Editing, Supervision.

Corresponding author

Correspondence to Carlos Alva-Diaz.

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The authors declare no conflicts of interest.

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The institutional review boards of the participating institutions approved this research protocol. For this type of study, formal consent was not required.

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The original article has been updated to correct affiliations of corresponding author Carlos Alva Diaz.

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Malaga, M., Rodriguez-Calienes, A., Marquez-Nakamatsu, A. et al. Predicting Mechanical Ventilation Using the EGRIS in Guillain–Barré Syndrome in a Latin American Country. Neurocrit Care 35, 775–782 (2021). https://doi.org/10.1007/s12028-021-01218-z

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