Guillain-Barre Syndrome Trend of Hospital Length of Stay, Complication Rate and Mortality Depending from Method of the Treatment: IVIg vs. PLEX

Objective: To investigate trend of hospital length of stay (LOS) by method of the treatment: intravenous immunoglobulins (IVIg) vs. plasma exchange (PLEX). To examine whether trends in GBS treatment method, hospital LOC and mortality differ by teaching status of hospital Background: Guillain-Barre syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy with an incidence in Europe and North America ranging from 1.1 to 1.8 per 100,000. The GBS is the most frequent cause of acute flaccid paralysis worldwide and considered as a neurological emergency. It is established that Immune therapy with PLEX or IVIg is effective in patients with GBS. Design/Methods: Data source: Nationwide Inpatient Sample (NIS); time period from January 2000 to December 2011. Inclusion criteria: GBS; Age≥18 years old. Exclusion criteria: patients Primary outcomes: The primary outcomes of interest is hospital length of stay (LOS) and mortality rate over time. Results: Urban Teaching Hospitals: Total GBS cases from 2000–2011 were 38548; Hospital LOS decreased, from 12.57 in 2000 to 11.47 in 2011; PLEX use slightly decreased; IVIg use increased, from 8% in 2000 to 32% in 2011; Mortality decreased from 2% in 2000 to 1% in 2011. Urban non-teaching Hospitals: Total GBS cases from 2000–2011 were 26,024. Hospital LOC decreased - 13.1 days in 2000 and 9.28 days in 2011; PLEX use slightly decreased; IVIg use increased, from 4% in 2000 to 25% in 2011; Mortality decreased, from 4% in 2000 to 2% in 2011. Conclusions: Analysis of NIS data for GBS from 2000 to 2011 show following trends: PLEX use decreased; IVIg use increased; Hospital length of stay decreased; Mortality decreased. Trends in GBS treatment method, hospital length of stay and mortality is not differ in teaching and not-teaching hospital. Disclosure: Dr. Gevorgyan, M.D., Ph.D. has nothing to disclose. Dr. Sanossian has recieved personal compensation for activities with Covidien Inc., serving on the clinical events committee and from Genentech as a speak.. Dr. Beydoun has received personal compensation for activities with Baxalta, Grifols, and Xenoport as a consultant, speaker and/or advisory board member. Dr. Beydoun has received personal compensation from Alexion, CSL, Daiichi, GlaxoSmithKline, and Pfizer.