Table_1_Sodium Levels Predict Disability at Discharge in Guillain-Barré Syndrome: A Retrospective Cohort Study.pdf

Guillain-Barré syndrome (GBS) is an inflammatory polyradiculopathy with potentially severe complications. Clinical tools for risk stratification have been developed, but no definitive prognostic biomarker has been reported. Hyponatremia is frequent in GBS patients, but the impact of serum sodium levels on clinical outcomes is still ill-defined. In this retrospective cohort study, we included all adult patients diagnosed with GBS spectrum disorders at our center from January 2010 to July 2020. Disability at discharge was assessed with the GBS Disability Score (GDS), and all clinical and laboratory data was retrieved from medical charts. Thirty (58.8%) of the 51 subjects included in the study were discharged with severe residual disability (GDS ≥ 3). After accounting for relevant confounders, the odds of experiencing severe disability decreased by 27% (p = 0.027) for each unitary increase in serum sodium concentration. Thirteen (25.5%) patients were diagnosed with mild to moderate hyponatremia; the use of intravenous immune globulin (IVIG) independently increased the odds of developing hyponatremia. In conclusion, we found a significant, independent association between baseline serum sodium levels and severe disability at discharge in GBS patients. In our cohort, hyponatremia was more frequently observed after treatment with IVIG, suggesting dilutional pseudohyponatremia as a probable cause.

吉兰-巴雷综合征（Guillain-Barré syndrome，简称 GBS）是一种具有潜在严重并发症的炎性多发性神经根病。针对风险分层，已开发出临床工具，但尚未报道确切的预后生物标志物。低钠血症在 GBS 患者中较为常见，然而血清钠水平对临床结果的影响尚不明确。在本项回顾性队列研究中，我们纳入了2010年1月至2020年7月期间在本中心被诊断为 GBS 谱系疾病的全部成年患者。出院时的残疾程度通过 GBS 残疾评分（GDS）进行评估，所有临床和实验室数据均从病历中提取。在纳入研究的51名受试者中，有30名（占比58.8%）在出院时伴有严重的残留残疾（GDS ≥ 3）。在考虑了相关混杂因素后，血清钠浓度每增加一个单位，发生严重残疾的几率降低27%（p = 0.027）。13名（占比25.5%）患者被诊断为轻度至中度低钠血症；静脉注射免疫球蛋白（IVIG）的使用独立地增加了发生低钠血症的几率。总之，我们发现基线血清钠水平与 GBS 患者出院时的严重残疾之间存在显著的独立关联。在我们的队列中，接受 IVIG 治疗后低钠血症的发病率更高，这表明稀释性假性低钠血症可能是其可能的病因。