Factors affecting the outcome of GBS patients admitted to SPHMMC and ZMH

Abstract

Abstract Background: Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy with significant mortality and disability. Outcomes in low- and middle-income countries are substantially poorer than in high-income settings, but institution-specific data from Ethiopia remain limited. Objective: To identify factors associated with in-hospital mortality and functional recovery among GBS patients admitted to St. Paul’s Hospital Millennium Medical College and Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Methods: A retrospective cohort study was conducted among 50 patients with GBS admitted between 2022 and 2026. Data on demographic, clinical, laboratory, treatment, and outcome variables were extracted from medical records. In-hospital mortality was the primary outcome. Functional recovery was assessed at discharge and at three months using the GBS Disability Score. Logistic regression was used to identify predictors of mortality. Results: The in-hospital mortality rate was 16% (8/50). The mean age was 35.2 years (SD 15.0), and 78% were male. Preceding diarrheal illness was reported in 38% of patients, and 52% required mechanical ventilation. In multivariable analysis, preceding diarrheal illness (adjusted odds ratio 11.88, 95% confidence interval 1.08–130.58, p=0.043) and mechanical ventilation (adjusted odds ratio 44.78, 95% confidence interval 1.94–1035.80, p=0.018) were independent predictors of mortality. Higher GBS disability score at admission was associated with mortality in univariate analysis (crude odds ratio 5.48 per one-point increase, p=0.035). At discharge, only 4% of patients had good functional recovery. Among 18 patients with three-month follow-up, 61% achieved good recovery. Conclusion: Mortality from GBS in Ethiopian referral hospitals remains high. Preceding diarrheal illness and the need for mechanical ventilation are strong independent predictors of death. Early risk stratification and improved access to respiratory support and immunomodulatory therapy are urgently needed to improve outcomes. Keywords: Guillain-Barré syndrome, mortality, mechanical ventilation, preceding diarrheal illness, Ethiopia, functional recovery