All Journals from Iain Crossingham
Abstract
Guillain-Barré syndrome (GBS) is an acute demyelinating disorder of the peripheral nervous system that results in motor weakness, absent reflexes and autonomic nervous system dysfunction. Autonomic failure is reported in approximately 65 % of patientswith GBS and usually follows extensive motor involvement. In this case our patient presented with syncope and other signs of autonomic failure before the motor weakness developed. Few cases in the literature have reported features of autonomic failure before established weakness in GBS; to our knowledge, syncope has not been described previously as a presenting feature of GBS.
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Abstract
The hospital standardised mortality ratio (HSMR) and the summary hospital mortality index (SHMI) are both in current use in the UK as measures of the performance of acute hospitals. Characteristics of both the acute hospital itself and of its local healthcare environment influence these indices. Whilst many hope that measures of mortality can be used as a surrogate for healthcare quality, this is an evolving area.
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