Li-Syue Liou1, Chi-Hsiang Chung2, Yung-Tsan Wu3, Chang-Huei Tsao4, Yung-Fu Wu5, Wu-Chien Chien6, Chih-Ya Chang7. 1. Department of Family and Community Medicine, Tri-Service General Hospital, Taiwan; Department of Family Medicine, Penghu Hospital, Ministry of Health and Welfare, Taiwan; School of Medicine, National Defense Medical Center, Taiwan. 2. School of Public Health, National Defense Medical Center, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taiwan. 3. School of Medicine, National Defense Medical Center, Taiwan; Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taiwan. 4. Department of Medical Research, Tri-Service General Hospital, Taiwan; Department of Microbiology & Immunology, National Defense Medical Center, Taiwan. 5. Department of Medical Research, Tri-Service General Hospital, Taiwan. 6. School of Public Health, National Defense Medical Center, Taiwan; Department of Medical Research, Tri-Service General Hospital, Taiwan. Electronic address: chienwu@ndmctsgh.edu.tw. 7. School of Medicine, National Defense Medical Center, Taiwan; Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taiwan. Electronic address: gradesboy@gmail.com.
Abstract
OBJECTIVE: The present study aimed to evaluate the characteristics of inpatient mortality from Guillain-Barré syndrome (GBS), which is a rare and potentially life-threatening polyradiculoneuropathy, in an Asian country, as there are few big-data studies regarding this topic. METHODS: We obtained data regarding patients with GBS from Taiwan's National Health Insurance Research Database admission records. We identified patients with a discharge diagnosis of GBS during 2000-2013 using the International Classification of Diseases, 9th Revision, Clinical Modification code (357.0), and evaluated their baseline characteristics, clinical complications, and risk factors. RESULTS: We identified 5469 patients with GBS, and the crude incidence of GBS was 1.71 per 100,000 person-years. The inpatient mortality rate was 1.61% (88/5469) and 55 deaths (62.5% of all deaths) occurred before day 19 of the hospitalization (mainly during the progressive phase). The predictors of inpatient mortality included older age, a greater comorbidity burden (especially catastrophic illness), endotracheal intubation, mechanical ventilation, cardiac complications, and systemic infection. In contrast, patients who were admitted to a medical center or Neurology Department exhibited a higher survival rate. CONCLUSIONS: This 14-year nationwide study included the largest analysis of Asian patients with GBS to date, and identified various prognostic factors that predicted inpatient mortality.
OBJECTIVE: The present study aimed to evaluate the characteristics of inpatient mortality from Guillain-Barré syndrome (GBS), which is a rare and potentially life-threatening polyradiculoneuropathy, in an Asian country, as there are few big-data studies regarding this topic. METHODS: We obtained data regarding patients with GBS from Taiwan's National Health Insurance Research Database admission records. We identified patients with a discharge diagnosis of GBS during 2000-2013 using the International Classification of Diseases, 9th Revision, Clinical Modification code (357.0), and evaluated their baseline characteristics, clinical complications, and risk factors. RESULTS: We identified 5469 patients with GBS, and the crude incidence of GBS was 1.71 per 100,000 person-years. The inpatient mortality rate was 1.61% (88/5469) and 55 deaths (62.5% of all deaths) occurred before day 19 of the hospitalization (mainly during the progressive phase). The predictors of inpatient mortality included older age, a greater comorbidity burden (especially catastrophic illness), endotracheal intubation, mechanical ventilation, cardiac complications, and systemic infection. In contrast, patients who were admitted to a medical center or Neurology Department exhibited a higher survival rate. CONCLUSIONS: This 14-year nationwide study included the largest analysis of Asian patients with GBS to date, and identified various prognostic factors that predicted inpatient mortality.