Hospital-diagnosed morbidities and recent surgery as risk factors for developing Guillain–Barré syndrome

Lotte S. Levison; Reimar W. Thomsen; Henning Andersen

doi:10.1111/ene.15955

Hospital-diagnosed morbidities and recent surgery as risk factors for developing Guillain–Barré syndrome

Lotte S. Levison^*, Reimar W. Thomsen, Henning Andersen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

Background and purpose: This study was undertaken to determine the association of hospital-diagnosed morbidity and recent surgery with risk of subsequent Guillain–Barré syndrome (GBS) development. Methods: We conducted a nationwide population-based case–control study of all patients with first-time hospital-diagnosed GBS in Denmark between 2004 and 2016 and 10 age-, sex-, and index date-matched population controls per case. Hospital-diagnosed morbidities included in the Charlson Comorbidity Index were assessed as GBS risk factors up to 10 years prior to the GBS index date. Incident major surgery was assessed within 5 months prior. Results: In the 13-year study period, there were 1086 incident GBS cases, whom we compared with 10,747 matched controls. Any pre-existing hospital-diagnosed morbidity was observed in 27.5% of GBS cases and 20.0% of matched controls, yielding an overall matched odds ratio (OR) of 1.6 (95% confidence interval [CI] = 1.4–1.9). The strongest associations were found for leukemia, lymphoma, diabetes, liver disease, myocardial infarction, congestive heart failure, and cerebrovascular disease, with 1.6- to 4.6-fold increased risks of subsequent GBS. GBS risk was strongest for morbidities newly diagnosed during the past 5 months (OR = 4.1, 95% CI = 3.0–5.6). Surgical procedures within 5 months prior were observed in 10.6% of cases and 5.1% of controls, resulting in a GBS OR of 2.2 (95% CI = 1.8–2.7). Risk of developing GBS was highest during the first month following surgery (OR = 3.7, 95% CI = 2.6–5.2). Conclusions: In this large nationwide study, individuals with hospital-diagnosed morbidity and recent surgery had a considerably increased risk of GBS.

Original language	English
Journal	European Journal of Neurology
Volume	30
Issue	10
Pages (from-to)	3277-3285
Number of pages	9
ISSN	1351-5101
DOIs	https://doi.org/10.1111/ene.15955
Publication status	Published - Oct 2023

Keywords

epidemiology
Guillain–Barré syndrome
neuropathy
Hospitals
Humans
Risk Factors
Case-Control Studies
Morbidity
Guillain-Barre Syndrome/etiology

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10.1111/ene.15955Licence: CC BY-NC

Euro J of Neurology - 2023 - Levison - Hospital‐diagnosed morbidities and recent surgery as risk factors for developingFinal published version, 328 KBLicence: CC BY-NC

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@article{1044f4cff59243afb1015d7c06ed6341,

title = "Hospital-diagnosed morbidities and recent surgery as risk factors for developing Guillain–Barr{\'e} syndrome",

abstract = "Background and purpose: This study was undertaken to determine the association of hospital-diagnosed morbidity and recent surgery with risk of subsequent Guillain–Barr{\'e} syndrome (GBS) development. Methods: We conducted a nationwide population-based case–control study of all patients with first-time hospital-diagnosed GBS in Denmark between 2004 and 2016 and 10 age-, sex-, and index date-matched population controls per case. Hospital-diagnosed morbidities included in the Charlson Comorbidity Index were assessed as GBS risk factors up to 10 years prior to the GBS index date. Incident major surgery was assessed within 5 months prior. Results: In the 13-year study period, there were 1086 incident GBS cases, whom we compared with 10,747 matched controls. Any pre-existing hospital-diagnosed morbidity was observed in 27.5% of GBS cases and 20.0% of matched controls, yielding an overall matched odds ratio (OR) of 1.6 (95% confidence interval [CI] = 1.4–1.9). The strongest associations were found for leukemia, lymphoma, diabetes, liver disease, myocardial infarction, congestive heart failure, and cerebrovascular disease, with 1.6- to 4.6-fold increased risks of subsequent GBS. GBS risk was strongest for morbidities newly diagnosed during the past 5 months (OR = 4.1, 95% CI = 3.0–5.6). Surgical procedures within 5 months prior were observed in 10.6% of cases and 5.1% of controls, resulting in a GBS OR of 2.2 (95% CI = 1.8–2.7). Risk of developing GBS was highest during the first month following surgery (OR = 3.7, 95% CI = 2.6–5.2). Conclusions: In this large nationwide study, individuals with hospital-diagnosed morbidity and recent surgery had a considerably increased risk of GBS.",

keywords = "epidemiology, Guillain–Barr{\'e} syndrome, neuropathy, Hospitals, Humans, Risk Factors, Case-Control Studies, Morbidity, Guillain-Barre Syndrome/etiology",

author = "Levison, {Lotte S.} and Thomsen, {Reimar W.} and Henning Andersen",

note = "Funding Information: This study received funding from the Bevica Foundation (AU‐904020), teacher Svend Aage Nielsen Wacherhausens Foundation (2017–1064/42), Aase and Ejnar Danielsen Foundation (10–002109), and A. P. M{\o}ller Foundation (17‐L‐0126). Funding Information: We thank biostatistician Eskild Bendix Kristiansen for skillful assistance in the data management process. This work received funding from the Bevica Foundation, teacher Svend Aage Nielsen Wacherhausens Foundation, Aase and Ejnar Danielsen Foundation, and A. P. M{\o}ller Foundation. Publisher Copyright: {\textcopyright} 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.",

year = "2023",

month = oct,

doi = "10.1111/ene.15955",

language = "English",

volume = "30",

pages = "3277--3285",

journal = "European Journal of Neurology",

issn = "1351-5101",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "10",

}

Hospital-diagnosed morbidities and recent surgery as risk factors for developing Guillain–Barré syndrome. / Levison, Lotte S.; Thomsen, Reimar W.; Andersen, Henning.
In: European Journal of Neurology, Vol. 30, No. 10, 10.2023, p. 3277-3285.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Hospital-diagnosed morbidities and recent surgery as risk factors for developing Guillain–Barré syndrome

AU - Levison, Lotte S.

AU - Thomsen, Reimar W.

AU - Andersen, Henning

N1 - Funding Information: This study received funding from the Bevica Foundation (AU‐904020), teacher Svend Aage Nielsen Wacherhausens Foundation (2017–1064/42), Aase and Ejnar Danielsen Foundation (10–002109), and A. P. Møller Foundation (17‐L‐0126). Funding Information: We thank biostatistician Eskild Bendix Kristiansen for skillful assistance in the data management process. This work received funding from the Bevica Foundation, teacher Svend Aage Nielsen Wacherhausens Foundation, Aase and Ejnar Danielsen Foundation, and A. P. Møller Foundation. Publisher Copyright: © 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

PY - 2023/10

Y1 - 2023/10

N2 - Background and purpose: This study was undertaken to determine the association of hospital-diagnosed morbidity and recent surgery with risk of subsequent Guillain–Barré syndrome (GBS) development. Methods: We conducted a nationwide population-based case–control study of all patients with first-time hospital-diagnosed GBS in Denmark between 2004 and 2016 and 10 age-, sex-, and index date-matched population controls per case. Hospital-diagnosed morbidities included in the Charlson Comorbidity Index were assessed as GBS risk factors up to 10 years prior to the GBS index date. Incident major surgery was assessed within 5 months prior. Results: In the 13-year study period, there were 1086 incident GBS cases, whom we compared with 10,747 matched controls. Any pre-existing hospital-diagnosed morbidity was observed in 27.5% of GBS cases and 20.0% of matched controls, yielding an overall matched odds ratio (OR) of 1.6 (95% confidence interval [CI] = 1.4–1.9). The strongest associations were found for leukemia, lymphoma, diabetes, liver disease, myocardial infarction, congestive heart failure, and cerebrovascular disease, with 1.6- to 4.6-fold increased risks of subsequent GBS. GBS risk was strongest for morbidities newly diagnosed during the past 5 months (OR = 4.1, 95% CI = 3.0–5.6). Surgical procedures within 5 months prior were observed in 10.6% of cases and 5.1% of controls, resulting in a GBS OR of 2.2 (95% CI = 1.8–2.7). Risk of developing GBS was highest during the first month following surgery (OR = 3.7, 95% CI = 2.6–5.2). Conclusions: In this large nationwide study, individuals with hospital-diagnosed morbidity and recent surgery had a considerably increased risk of GBS.

AB - Background and purpose: This study was undertaken to determine the association of hospital-diagnosed morbidity and recent surgery with risk of subsequent Guillain–Barré syndrome (GBS) development. Methods: We conducted a nationwide population-based case–control study of all patients with first-time hospital-diagnosed GBS in Denmark between 2004 and 2016 and 10 age-, sex-, and index date-matched population controls per case. Hospital-diagnosed morbidities included in the Charlson Comorbidity Index were assessed as GBS risk factors up to 10 years prior to the GBS index date. Incident major surgery was assessed within 5 months prior. Results: In the 13-year study period, there were 1086 incident GBS cases, whom we compared with 10,747 matched controls. Any pre-existing hospital-diagnosed morbidity was observed in 27.5% of GBS cases and 20.0% of matched controls, yielding an overall matched odds ratio (OR) of 1.6 (95% confidence interval [CI] = 1.4–1.9). The strongest associations were found for leukemia, lymphoma, diabetes, liver disease, myocardial infarction, congestive heart failure, and cerebrovascular disease, with 1.6- to 4.6-fold increased risks of subsequent GBS. GBS risk was strongest for morbidities newly diagnosed during the past 5 months (OR = 4.1, 95% CI = 3.0–5.6). Surgical procedures within 5 months prior were observed in 10.6% of cases and 5.1% of controls, resulting in a GBS OR of 2.2 (95% CI = 1.8–2.7). Risk of developing GBS was highest during the first month following surgery (OR = 3.7, 95% CI = 2.6–5.2). Conclusions: In this large nationwide study, individuals with hospital-diagnosed morbidity and recent surgery had a considerably increased risk of GBS.

KW - epidemiology

KW - Guillain–Barré syndrome

KW - neuropathy

KW - Hospitals

KW - Humans

KW - Risk Factors

KW - Case-Control Studies

KW - Morbidity

KW - Guillain-Barre Syndrome/etiology

UR - http://www.scopus.com/inward/record.url?scp=85164517569&partnerID=8YFLogxK

U2 - 10.1111/ene.15955

DO - 10.1111/ene.15955

M3 - Journal article

C2 - 37368224

AN - SCOPUS:85164517569

SN - 1351-5101

VL - 30

SP - 3277

EP - 3285

JO - European Journal of Neurology

JF - European Journal of Neurology

IS - 10

ER -

Hospital-diagnosed morbidities and recent surgery as risk factors for developing Guillain–Barré syndrome

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