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

Abstract

AbstractBackground and purposeThis study was undertaken to determine the association of hospital‐diagnosed morbidity and recent surgery with risk of subsequent Guillain–Barré syndrome (GBS) development.MethodsWe 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.ResultsIn 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).ConclusionsIn this large nationwide study, individuals with hospital‐diagnosed morbidity and recent surgery had a considerably increased risk of GBS.