Validation of Erasmus GBS Outcome Score in an International Study

Guillain-Barré syndrome (GBS) is an acute immune-mediated neuropathy that has a variable course and outcome across regions. The modified Erasmus GBS Outcome Score (mEGOS) is a prognostic model designed to predict the functional outcome of GBS patients at 1 and 6 months. The first study objective was to validate the mEGOS in the International GBS Outcome Study (IGOS) cohort and to determine its performance in different regions. The second objective was to improve the mEGOS predictions by including region-specific adjustments. In western GBS patients, the most frequent form is the demyelinating subtype, involving both sensory and motor nerves. In Asia, the Miller Fisher syndrome is more frequent, and its outcome is better.

This analysis included 809 patients: 677 from Europe or North America, 76 from Asia, and 56 from elsewhere. Patients with the Miller Fisher syndrome were included. In the Europe/North America group, outcomes were worse than the mEGOS predicted; in the Asia group, outcomes were better than predicted. Recalibration made the model more accurate and permitted the development of a region-specific version for Europe/North America (mEGOS-Eu/NA). As in the mEGOS development cohort, older age and severe limb weakness were the most frequent predictors of poor outcome in the IGOS cohort.