Predictive Performance of Erasmus Guillain-Barré syndrome (GBS) Respiratory Insufficiency Score and Modified Erasmus GBS Outcome Score for Clinical Outcomes in Pediatric GBS

To evaluate the predictive value of the Erasmus Guillain-Barré syndrome (GBS) Respiratory Insufficiency Score (EGRIS) and the modified Erasmus GBS Outcome Score (mEGOS) for outcome in a pediatric cohort. The study group consisted of 32 GBS patients (n = 9 with axonal form, 28.1%) who received standard intravenous immunoglobulin therapy. The unfavorable outcome was defined as the inability to walk independently (with GBS disability score ≥3) at 6 months. Receiver operating characteristic (ROC) curve analyses were performed using both scoring systems to evaluate their predictive accuracy for early outcomes (need for mechanical ventilation and intensive care unit [ICU] admission) and for late motor outcome at 6 months. EGRIS yielded a strong accuracy (area under the curve [AUC] of 0.96 (95% CI: 0.85-1.00; cutoff ≥ 5) for predicting the need for mechanical ventilation and an AUC of 0.81 (95% CI: 0.63-1.00) for predicting ICU admission. The mEGOS score calculated at admission was significantly higher in the axonal subgroup ( P  = .011). The mEGOS demonstrated strong predictive ability for ICU admission at presentation (AUC = 0.89; 95% CI: 0.74-1.00; cutoff ≥ 4). However, both EGRIS and mEGOS exhibited limited discriminative ability in identifying patients with mild neurologic disability at 6 months (AUC < 0.70). The EGRIS and mEGOS demonstrated strong predictive accuracy for early outcomes and limited discriminative ability for late motor outcomes. We considered that both scoring systems should be integrated into pediatric-specific prognostic frameworks at the bedside of GBS patients with electroclinical subtypes.