Ratio of neutrophil to lymphocytes, albumin and sodium levels as predictive markers of Post-Plasmapheresis clinical response in Guillain Barre Syndrome (SGB) patients

Guillain-Barré Syndrome (GBS) is an acute autoimmune disorder of the peripheral nervous system that can cause progressive paralysis and may be life-threatening.Plasmapheresis has long been established as a primary immunomodulatory therapy for patients with GBS; however, post-treatment clinical responses vary considerably among patients.Therefore, simple, readily available, and clinically applicable predictive markers are needed to help estimate patient outcomes.This study aimed to analyze the roles of the neutrophil-to-lymphocyte ratio (NLR), serum albumin levels, and serum sodium levels as predictive markers of clinical response following plasmapheresis in patients with Guillain-Barré syndrome.This study employed a cross-sectional design using secondary data obtained from the medical records of GBS patients who underwent plasmapheresis at Dr. Saiful Anwar General Hospital, Malang.A total of 84 patients who met the inclusion criteria were analyzed and classified into good and poor clinical response groups based on post-treatment outcomes.Statistical analyses were performed using the Mann-Whitney test and prevalence ratio calculations.The results demonstrated that patients with normal or low NLR values were 2.5 times more likely to exhibit a good clinical response compared with those with high NLR values (p = 0.001).In addition, normal or high serum albumin levels were significantly associated with better clinical responses (PR = 2.13; p = 0.003).In contrast, serum sodium levels showed no statistically significant association with clinical response after plasmapheresis (p = 0.970).In conclusion, NLR and serum albumin levels have the potential to serve as predictive markers of clinical response in patients with GBS following plasmapheresis, whereas serum sodium levels were not shown to be significant predictors.These findings are expected to support clinical decisionmaking and improve risk stratification in patients with Guillain-Barré syndrome.