Guillain-Barré Syndrome Triggered by Surgery in Chinese population: Towards a Multicenter Retrospective Study

Abstract

BackgroundSurgery is described as a potential trigger of Guillain-Barré syndrome (GBS). The present study was designed to explore the clinical feature of post-surgical GBS compared with those of general GBS, to give better clinical advice to patients undergoing surgery. MethodsWe retrospectively analyzed medical records of GBS patients in 31 representative tertiary hospitals, located in 14 provinces in southern China, between 1 January 2013 and 30 September 2016. Post-surgical GBS was defined as symptoms of GBS within 6 weeks after surgery. We described clinical feature of post-surgical GBS, and assessed the difference between post-surgical GBS and the general GBS.ResultsOf the 1001 GBS patients enrolled, 45 patients (4.5%) had undergone surgery within 6 weeks before GBS symptom onset. Among them, 36 patients (80.0%) developed initial symptoms of limb weakness. The average interval between surgery and symptom onset was 13.31 days. The most common type of surgery triggering GBS was orthopedic surgery, followed by neurological surgery. Compared to the general GBS, post-surgical GBS was characterized by higher proportion of severe patients (HFGS ≥3) on admission and at nadir, higher HFGS score at discharge, and longer hospital stays. Besides, the post-surgical GBS patients had a significantly higher frequency of the subtype of AMAN (37.9 vs 14.2, P=0.001).ConclusionSurgery was a potential trigger factor for GBS, especially in orthopedic surgery. The clinical presentation of postsurgical GBS was characterized by a more severe course and poorer prognosis. Clinical trial registrationchicTR-RRc-17014152.