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Acero-Garces D, Zuluaga-Lotero D, Ortiz-Muñoz D, Arango GP, Moyano M, Vargas-Manotas J, Rojas CA, Urrego J, Rojas JP, Rosso F, Ramos-Burbano GE, Llanos MD, Lizarazo J, Lopez-Gonzalez R, Jimenez-Arango JA, Benavides-Melo J, Martinez-Villota VA, Gonzalez G, Dominguez-Penuela SC, Quintero JA, Luque KA, Ruiz AM, Claros K, Osorio L, Pardo CA, Parra B. Long-term outcomes of patients affected by Guillain-Barré syndrome in Colombia after the Zika virus epidemic. J Neurol Sci 2024; 463:123140. [PMID: 39047509 DOI: 10.1016/j.jns.2024.123140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/08/2024] [Accepted: 07/14/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Guillain-Barré Syndrome (GBS) can lead to significant functional impairments, yet little is understood about the recovery phase and long-term consequences for patients in low- and medium-income countries. OBJECTIVE To evaluate the functional status and identify factors influencing outcomes among patients with GBS in Colombia. METHODS Telephone interviews were conducted with GBS patients enrolled in the Neuroviruses Emerging in the Americas Study between 2016 and 2020. The investigation encompassed access to health services and functional status assessments, utilizing the modified Rankin Scale (mRS), GBS Disability Score (GDS), Barthel Index (BI), and International Classification of Functioning (ICF). Univariate analysis, principal component analysis, linear discriminant analysis, and linear regression were employed to explore factors influencing functional status. RESULTS Forty-five patients (mean age = 50[±22] years) with a median time from diagnosis of 28 months (IQR = 9-34) were included. Notably, 22% and 16% of patients did not receive rehabilitation services during the acute episode and post-discharge, respectively. Most patients demonstrated independence in basic daily activities (median BI = 100, IQR = 77.5-100), improvement in disability as the median mRS at follow-up was lower than at onset (1 [IQR = 0-3] vs. 4.5 [IQR = 4-5], p < 0.001), and most were able to walk without assistance (median GDS = 2, IQR = 0-2). A shorter period from disease onset to interview was associated with worse mRS (p = 0.015) and ICF (p = 0.019). Negative outcomes on GDS and ICF were linked to low socioeconomic status, ICF to the severity of weakness at onset, and BI to an older age. CONCLUSIONS This study underscores that the functional recovery of GBS patients in Colombia is influenced not only by the natural course of the disease but also by socioeconomic factors, emphasizing the crucial role of social determinants of health.
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Affiliation(s)
| | | | | | - Gloria P Arango
- Universidad Del Valle, School of Human Rehabilitation, Faculty of Health, Cali, Colombia
| | - Martha Moyano
- Universidad Del Valle, School of Public Health, Cali, Colombia
| | - José Vargas-Manotas
- Universidad Simón Bolívar, Barranquilla, Colombia; La Misericordia Clínica Internacional, Barranquilla, Colombia
| | - Christian A Rojas
- Universidad del Valle, School of Medicine, Cali, Colombia; Hospital Universitario del Valle, Cali, Colombia; Clinica Imbanaco, Department of Pediatrics, Cali, Colombia
| | - Jonathan Urrego
- Universidad del Valle, School of Medicine, Cali, Colombia; Hospital Universitario del Valle, Cali, Colombia
| | - Juan P Rojas
- Fundación Clínica Infantil Club Noel, Department of Pediatrics, Cali, Colombia; Universidad Libre seccional Cali, Cali, Colombia
| | - Fernando Rosso
- Fundación Valle del Lili, Department of Internal Medicine, Cali, Colombia; Universidad ICESI, Cali, Colombia
| | - Gustavo E Ramos-Burbano
- Universidad del Valle, School of Medicine, Cali, Colombia; Clinica Rey David, Cali, Colombia
| | | | - Jairo Lizarazo
- Hospital Universitario Erasmo Meoz, Cúcuta, Colombia; Universidad de Pamplona, Cúcuta, Colombia
| | | | | | | | | | - Guillermo Gonzalez
- Hospital Universitario de Neiva Hernando Moncaleano Perdomo, Neiva, Colombia; Universidad Surcolombiana, Neiva, Colombia
| | | | - Jaime A Quintero
- Universidad del Valle, Department of Microbiology, Cali, Colombia
| | | | | | - Katherinne Claros
- Hospital Universitario de Neiva Hernando Moncaleano Perdomo, Neiva, Colombia
| | - Lyda Osorio
- Universidad Del Valle, School of Public Health, Cali, Colombia
| | - Carlos A Pardo
- Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, MD, USA.
| | - Beatriz Parra
- Universidad del Valle, Department of Microbiology, Cali, Colombia
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