Neurol Sci

Objective: To describe incidence and clinical characteristics of cases of Guillain-Barré Syndrome (GBS) in the United States during 2009–2015, and characteristics of GBS cases with antecedent cytomegalovirus (CMV) infection among persons with employer-sponsored insurance. Methods: We analyzed medical claims from IBM Watson MarketScan® databases. GBS patients were defined as enrollees with an inpatient claim with GBS as the principal diagnosis code, based on ICD-9 or ICD-10, and ≥1 claim for lumbar puncture or EMG/nerve conduction study. We assessed intensive care unit (ICU) hospitalization, intubation, dysautonomia, and death. We also assessed selected infectious illness within 60 days prior to first GBS-coded inpatient claim. Results: We identified 3,486 GBS patients; annual incidence of 1.0–1.2/100,000 persons during 2009–2015. GBS incidence was higher in males (1.2/100,000) than females (0.9/100,000) (p=0.006) and increased with age, from 0.4/100,000 in persons 0–17 years old to 2.1/100,000 in persons ≥65 years old (p<0.001). Half of GBS patients were hospitalized in the ICU, 8% were intubated, 2% developed dysautonomia, and 1% died. Half had a claim for antecedent illness, but only 125 (3.5%) had a claim for specific infectious pathogens. The mean age among 18 GBS patients with antecedent CMV infection was 39 years versus 47 years among those without antecedent CMV infection (p=0.038). Conclusions: Incidence of GBS using a large national claims database was comparable to that reported in the literature, but cases appeared to be less severe. Half of GBS patients reported prior infectious illness, but only a minority had a specific pathogen identified.

Neurol Sci. 41(4):885-891

31828680

PMC7501740

CDC Public Access