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Abstract
Objective To assess the association between Guillain-Barré syndrome (GBS) and recent surgery based on French nationwide data.
Methods Data were extracted from the French health administrative databases (SNIIRAM/PMSI). All patients hospitalized for GBS between 2009 and 2014 were identified by ICD-10 code G61.0 as main diagnosis. Patients previously hospitalized for GBS in 2006, 2007, and 2008 were excluded. Surgical procedures were identified from the hospital database. Hospitalizations for surgery with no infection diagnosis code entered during the hospital stay were also identified. The association between GBS and a recent surgical procedure was estimated using a case-crossover design. Case and referent windows were defined as 1–60 days and 366–425 days before GBS hospitalization, respectively. Analyses were adjusted for previous episodes of gastroenteritis and respiratory tract infection, identified by drug dispensing data.
Results Of the 8,364 GBS cases included, 175 and 257 patients had undergone a surgical procedure in the referent and case windows, respectively (adjusted odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.25–1.88). A slightly weaker association was observed for surgical procedures with no identified infection during the hospitalization (OR = 1.40, 95% CI: 1.12–1.73). Regarding the type of surgery, only surgical procedures on bones and digestive organs were significantly associated with GBS (OR and 95% CI = 2.78 [1.68–4.60] and 2.36 [1.32–4.21], respectively).
Conclusion In this large nationwide epidemiologic study, GBS was moderately associated with any type of recent surgery and was more strongly associated with bone and digestive organ surgery.
Glossary
- CI=
- confidence interval;
- GBS=
- Guillain-Barré syndrome;
- ICD-10=
- International Classification of Diseases, Tenth Revision;
- OR=
- odds ratio;
- PMSI=
- Programme de Médicalisation des Systèmes d'Information;
- SNIIRAM=
- Système National d'Information Interrégimes de l'Assurance Maladie
Footnotes
↵* These authors contributed equally to this work.
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
CME Course: NPub.org/cmelist
- Received February 19, 2018.
- Accepted in final form June 28, 2018.
- © 2018 American Academy of Neurology
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- Author response to Dr. Steiner
- Guillain-Barré syndrome following surgery
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