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Guillain–Barré syndrome

Incidence and mortality rates in US hospitals

From the Neurological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH.

Address correspondence and reprint requests to Dr. Amer Alshekhlee, Department of Neurology, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106-5040 amer.alshekhlee{at}uhhospitals.org

Objective: To determine the incidence, in-hospital mortality, and predictors of death in Guillain–Barré syndrome (GBS) in a large US cohort.

Methods: Our cohort was identified from the Nationwide Inpatient Sample database, 2000 through 2004. We excluded patients younger than 18 years and those who presented with rapidly paralyzing conditions due to other causes. GBS patients who were transferred between hospitals were counted once. The incidence rate adjusted for 20% of the US census reported by the Census Bureau. A logistic regression model was used to identify predictors of death.

Results: After data cleansing, 4,954 patients were identified with a primary diagnosis of GBS. The adjusted incidence rate varied between 1.65 and 1.79 per 100,000 during the years included in this study. The in-hospital mortality rate was 2.58% (128/4,954) and did not change significantly over the study period. Eleven percent had variable pulmonary complications, and 9.1% received endotracheal intubation, which was a predictor of mortality (adjusted odds ratio 5.09, 95% CI 3.21–8.05). Other predictors of mortality included older age, composite comorbidity index, cardiac complications, and sepsis.

Conclusion: The mortality rate in Guillain–Barré syndrome is low, and predictors of death are similar to those predicting poor disability outcome. The disease incidence was stable over the 5 years included in this study.

GLOSSARY: ICD-9-CM = International Classification of Diseases, 9th Revision, Clinical Modification; ICF = intermediate care facility; IQR = interquartile range; GBS = Guillain–Barré syndrome; NIS = Nationwide Inpatient Sample; OR = odds ratio; SNF = skilled nursing facility.

Supplemental data at www.neurology.org

Disclosure: The authors report no conflicts of interest.

Received September 13, 2007. Accepted in final form January 3, 2008.