Hospital Admissions, Transfers and Costs of Guillain-Barré Syndrome

Abstract

BackgroundGuillain-Barré syndrome (GBS) has a highly variable clinical course, leading to frequent transfers within and between hospitals and high associated costs. We defined the current admissions, transfers and costs in relation to disease severity of GBS.MethodsDutch neurologists were requested to report patients diagnosed with GBS between November 2009 and November 2010. Information regarding clinical course and transfers was obtained via neurologists and general practitioners.Results87 GBS patients were included with maximal GBS disability score of 1 or 2 (28%), 3 or 4 (53%), 5 (18%) and 6 (1%). Four mildly affected GBS patients were not hospital admitted. Of the 83 hospitalized patients 68 (82%) were initially admitted at a neurology department, 4 (5%) at an ICU, 4 (5%) at pediatrics, 4 (5%) at pediatrics neurology and 3 (4%) at internal medicine. Median hospital stay was 17 days (IQR 11–26 days, absolute range 1–133 days). Transfers between departments or hospitals occurred in 33 (40%) patients and 25 (30%) were transferred 2 times or more. From a cost-effectiveness perspective 21 (25%) of the admissions was suboptimal. Median costs for hospital admission of GBS patients were 15,060 Euro (IQR 11,226–23,683). Maximal GBS disability score was significantly correlated with total length of stay, number of transfers, ICU admission and costs.ConclusionsHospital admissions for GBS patients are highly heterogeneous, with frequent transfers and higher costs for those with more severe disease. Future research should aim to develop prediction models to early identify the most cost-effective allocation in individual patients.

Neurological complications associated with emerging viruses in Brazil

“…To fill this gap, there is a need for public health decision makers to assure the supply of intravenous immunoglobulin in the public health institutions network. This would likely reduce the need for transfers, which worsen GBS patient outcomes and are costly . We found that it is possible to predict the timing and location of hospitalizations with GBS with a statistical model using data on arbovirus cases.…”

Dysregulation of RNA editing may help explain pathogenicity mechanisms of congenital Zika syndrome and Guillain-Barre syndrome

“…Despite recent progress in immunotherapy [37] , GBS remains a life-threatening condition, often requiring complex and expensive care [38] . Up to 20% of GBS cases result in severe disability, or even death [36] , while many other patients experience ongoing motor or sensory issues, fatigue and pain [39] .…”

“…Nonetheless, GBS is associated with substantial risks (including death) as well as financial costs for affected individuals [21] . Moreover, there are challenges with early GBS diagnosis, particular in atypical presentations and/or pediatric patients [38] . For example, cranial nerve enhancement -thought to be a part of GBS in pediatric patients [40] -was recently described from an imaging study of seemingly normal infant born after ZIKVpositive pregnancy.…”

Синдром Гійєна — ​Барре При Запальних Захворюваннях Суглобів

“…К нередким внесуставным (системным) проявлениям воспалительных заболеваний суставов относятся различные поражения нервной системы, а в клиническом их течении важное значение имеет наличие и тяжесть периферической нейропатии (ПНП) [8], частота возникновения которой среди таких пациентов составляет 5-10 % [9,15]. Одним из вариантов ПНП при артритах является синдром Гийена -Барре (СГБ) [7], который обычно значительно ухудшает характер заболеваний [16], а с возрастом частота СГБ у пациентов растет [10]. Известны случаи возникновения СГБ при ревматоидном артрите (РА), хроническом хламидийном урогенитальном реактивном артрите (РеА), псориатическом артрите (ПА) и анкилозирующем спондилите (АС) на фоне лечения противоцитокиновыми препаратами, в частности ингибиторами туморонекротического фактора  [13,14,18].…”