The epidemiology of Guillain‐Barré syndrome in Thailand over 13 years (2005‐2017): A nationwide population‐based retrospective cohort study

Abstract

There have been no published studies examining the epidemiology of Guillain-Barré syndrome (GBS) in large populations in Thailand. This study aimed to explore the incidence, patient characteristics, seasonality, treatments, and outcomes of GBS in Thailand. The National Health Security Office (NHSO) provided data on in-patient admission between fiscal year 2005 and 2017. We selected all patients with a primary diagnosis of GBS. We retrieved data regarding the total population from the Department of Provincial Administration. A total of 4521 patients with GBS were included. The median age was 42 years (IQR 22-56), and 61.5% were male. The incidence rate increased from 0.48 to 0.93 per 100 000 population over the 13 years.The incidence was increased with age and a male-to-female ratio of 1.6:1. There was seasonal variation in the rate of admission for GBS, with significantly more patients admitted in rainy vs summer (IRR 1.94, 95%CI 1.80-2.10, P < .001) and winter vs summer (IRR 1.48, 95%CI 1.36-1.60, P < .001). Treatment with IVIg increased from 4.4% to 29.6% (P < .001), whereas plasmapheresis decreased significantly from 4% to 1.32% (P = .017). The mortality rate was 3.5%. Elderly and young adults had a significantly higher mortality rate when compared to children and teenagers (P < .001 and P = .003). The incidence of GBS in Thailand was steady over 13 years and was greater in rainy and winter season. Treatment with IVIg increased while plasmapheresis decreased. Mortality was higher in elderly patients.

Clinical predictors and electrodiagnostic characteristics in patients with Guillain-Barré syndrome with respiratory failure: a retrospective, matched case-control study

“…Compared to previous epidemiological studies in Thailand, our patients with respiratory failure were older (50.6 vs. 42.0–43.0 years), which correlates to previous findings in which the mortality rate in the older age group was higher than the younger age group (5.2% in patients age ≥ 65 years compared to 1.5% and 3.6% in patients age ≥ 18 and 19–64 years, respectively) ( Areeyapinan & Phanthumchinda, 2010 ; Kasemsap et al, 2021 ; Wen et al, 2021 ). Similarly, Shangab & Al Kaylani (2021) reported that older age at presentation is a major predictor for the need for mechanical ventilation (MV).…”

“…This observation is different from a meta-analysis that revealed that men were no more likely to require MV ( Green, Baker & Subramaniam, 2018 ) but was consistent with previous studies in Bangladesh and the United Arab Emirates, which showed that 68–78% of ventilated patients were male ( Shangab & Kaylani, 2021 ; Islam et al, 2019 ). The seasonal prevalence of GBS was comparable to previous studies confirming that the rainy and winter seasons had significantly more patients ( Areeyapinan & Phanthumchinda, 2010 ; Kasemsap et al, 2021 ).…”

“…Similarly, Shangab & Al Kaylani (2021) reported that older age at presentation is a major predictor for the need for mechanical ventilation (MV). Additionally, we found a higher male-to-female ratio of 2.6:1 compared to 1.6:1 in overall GBS, suggesting that males might have a higher morbidity than females ( Kasemsap et al, 2021 ). This observation is different from a meta-analysis that revealed that men were no more likely to require MV ( Green, Baker & Subramaniam, 2018 ) but was consistent with previous studies in Bangladesh and the United Arab Emirates, which showed that 68–78% of ventilated patients were male ( Shangab & Kaylani, 2021 ; Islam et al, 2019 ).…”

“…The worldwide incidence of GBS is approximately 1.1–1.8 cases per 100000 ( McGrogan et al, 2009 ). Incidence increases with age and is higher in men ( Sejvar et al, 2011 ; Kasemsap et al, 2021 ). Respiratory failure is a common complication of GBS, caused by respiratory muscle weakness and impaired secretion clearance ( Green, Baker & Subramaniam, 2018 ).…”

Article Topic: Neuropathies Due to Infections and Antimicrobial Treatments

“…Close to a third of the patients develop respiratory failure [ 39 ]. GBS is the most common cause of acute neuromuscular paralysis worldwide, with an annual incidence estimated between 0.4 and 4/100,000 [ 40 – 43 ]. Incidence increases during the rainy season in tropical countries [ 43 , 44 ].…”