Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jun 15, 2020)
Date Submitted: May 23, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Epidemiology of Guillain-Barré syndrome in Thailand over 13 years (2005 – 2017): A nationwide population-based retrospective cohort study
ABSTRACT
Background:
There have been no published studies examining the epidemiology of Guillain-Barré syndrome (GBS) in large populations in Thailand.
Objective:
This study aimed to explore the incidence, patient characteristics, seasonality, and geographical distribution of GBS in Thailand.
Methods:
The National Health Security Office (NHSO) provided data on inpatient admission between 2005 and 2017. We selected all in-patients with a primary diagnosis of GBS based on the International Classification of Disease-10 (ICD-10) codes. The ICD-9 codes were used for plasmapheresis and intravenous immunoglobulin (IVIg). We retrieved data regarding the total population in Thailand from the Department of Provincial Administration.
Results:
A total of 5,688 patients with GBS were included. The median age was 42 years, and 61.6% were male. The incidence rate increased from 0.54 to 1.22 per 100,000 population over the 13 years. The incidence was higher in late rainy season and early winter, although no pattern of seasonality was observed (P = .53). Overall in-hospital mortality was 3.2% and was significantly higher in elderly patients (5.4%) than in younger adults (3.4%) and children (1.4%; P < .001). Treatment with IVIg increased from 4.72% through 25.12% over the 13-year period (P < .001).
Conclusions:
The incidence rate of GBS gradually increased over the study period, especially in elderly patients, who also had a higher rate of mortality than patients in other age groups. There was no seasonal variation in the incidence of GBS in Thailand. Treatment with IVIg drastically increased over time and was more common than treatment with PE.
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