Hospital admissions for Guillain-Barre syndrome in the United States, 1993-2004

Background: The hospitalization rate for Guillain-Barre syndrome (GBS) in the USA has recently decreased. This study examined which demographic groups were affected and whether there were any changes in medical care that might explain the decrease. Methods: Information about hospitalizations for GBS was obtained from the 1993 - 2004 annual Nationwide Inpatient Sample and used to estimate hospitalization rates and the medical characteristics of hospitalized GBS patients. Results: The GBS hospitalization rate decreased 20.1% (95% CI 18.3 - 21.9%) between 1993 and 2004. Most groups were affected by the decrease except persons aged 18 - 44 years. There were several changes in medical care during the period, including a reduction in interhospital transfers and a shift from plasmapheresis to intravenous immunoglobulin ( IVIg) therapy. Conclusions: The reduction in transfers accounted for about one-fourth of the decrease in the GBS hospitalization rate, and may have been related to the shift from plasmapheresis to IVIg therapy. The other causes of the decrease are unknown.