Association of Admission Serum Albumin Level With 90-Day Functional Outcome in Patients with Guillain-Barré Syndrome: An Observational Study

Open Access

Abstract

Introduction: Guillain-Barré syndrome (GBS) is an acute immune-mediated peripheral neuropathy that can result in substantial disability despite appropriate treatment. Serum albumin is a routinely available and inexpensive laboratory parameter that may reflect systemic inflammation and disease severity. The study aimed to assess the association between admission serum albumin level and 90-day functional outcome in patients with Guillain-Barré syndrome. Methods & Materials: This observational study was conducted in the Department of Neurology and Department of Medicine, Dhaka Medical College Hospital (DMCH), Dhaka, over a period of 24 months from July 2018 to June 2020. A total of 55 patients were recruited by purposive sampling. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23.0. Result: At admission, GBS disability scores were comparable between hypoalbuminaemic and normoalbuminaemic groups; however, at the 90th day, disability was significantly greater in the hypoalbuminaemic group (3.0±1.76 vs. 1.86±0.46, p=0.001). Poor outcome occurred in 64% of hypoalbuminaemic patients compared with 5% of normoalbuminaemic patients (p=0.001). Serum albumin showed a significant inverse correlation with 90-day disability score (r=−0.424, p=0.001), and ROC analysis identified 3.30 g/dL as the optimal cut-off, with 96% sensitivity, 78% specificity, and AUC 0.952 (p=0.001) for predicting poor outcome. Conclusion: Lower admission serum albumin was significantly associated with poorer 90-day functional outcome in patients with Guillain-Barré syndrome. Although hypoalbuminemia was present in only 20% of patients, those with reduced albumin had significantly higher disability at the 90th day, with poor outcome occurring in 64% of the hypoalbuminaemic group compared with 5% of the normoalbuminaemic group (p=0.001). Moreover, serum albumin showed a significant inverse correlation with 90-day GBS disability score (r=−0.424, p=0.001), indicating greater disability with lower albumin levels. ROC analysis identified 3.30 g/dL as the optimal cut-off, providing 96.0% sensitivity and 78.0% specificity, with an AUC of 0.952 (95% CI: 0.883-1.000; p=0.001).