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The objective of this study was to determine the associations of liver function, easily available and convenient biomarkers, with the clinical course and outcome of severe GBS in patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective data collection was conducted in a cohort of 343 GBS patients from multi\u2010centers between September 2019 and December 2023. Serum samples were obtained at four\u2010time points for mechanical ventilation (MV) patients and two\u2010time points for non\u2010MV patients. The primary endpoint was the need for MV during hospitalization, while secondary outcomes included the ability to walk independently and the mortality at 26\u2010week follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>(i) A total of 208 patients were eligible, of whom 50 required MV with a median (interquartile range) ventilation duration of 15 (8\u201327) days. (ii) Hypohepatia, as evidenced by reduced total protein (OR 0.913 [95% CI 0.862\u20130.967]) and albumin (0.775 [0.679\u20130.884]) 1\u2009week after treatment, along with raised liver enzymes (2.732 [1.007\u20137.413]), was associated with the risk of MV after adjusting for confounders. (iii) After 26\u2010week follow\u2010up, patients with hypohepatia were less likely to regain independent walking and exhibited higher mortality in survival analysis (all log\u2010rank <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). (iv) In a cross\u2010sectional study spanning up to 4\u2009years of follow\u2010up, patients with prolonged MV (\u226515\u2009days) experienced a longer time to regain independent ambulation than those with shorter MV (167 [46\u2013316] vs. 69 [24\u2013106], <jats:italic>p<\/jats:italic>\u2009=\u2009.036). However, no relationships between liver function and prolonged MV were revealed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Dynamically monitoring hepatic metabolism and promptly adjusting, it can aid the improvement of GBS in patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jns.12661","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T02:44:22Z","timestamp":1727664262000},"page":"415-427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of dynamic hepatic metabolism with clinical outcomes in patients with severe Guillain\u2010Barr\u00e9 syndrome: A prospective cohort study from multi\u2010centers in China"],"prefix":"10.1111","volume":"29","author":[{"given":"Jiali","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Neurology, Shanghai East Hospital School of Medicine, Tongji University  Shanghai 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