Incidence of Guillain-Barré Syndrome Linked With Recent Bone, Digestive Organ Surgery

surgeons operating
surgeons operating
A nationwide epidemiologic study in France examined a correlation between Guillain-Barré syndrome and recent bone or digestive organ surgery.

In a study published in Neurology, French researchers found the development of Guillain-Barré syndrome (GBS) may follow recent surgery, particularly surgery pertaining to bones and digestive organs.

The Système National d’Information Inter-régimes de l’Assurance Maladie and Programme de Médicalisation des Systèmes d’Information databases were used to collect data on patients who were hospitalized for GBS. To investigate the association between GBS and surgery, the researchers also identified and extracted surgical procedure data from linked databases. A case-crossover design was used to assess the association, with case windows defined as 1 to 60 days and referent windows defined as 366 to 425 days before hospitalization for GBS.

A total of 8364 cases of GBS were included. Of these cases, the investigators identified patients who had undergone surgery during the case windows (n=257) and referent windows (n=175). After adjustment for gastroenteritis and respiratory tract infection, the odds ratio for the association between GBS and recent surgery was higher (adjusted odds ratio [aOR] 1.53; 95% CI, 1.25-1.88) whereas the OR was lower when surgical procedures in which there was no identified infection during hospitalization were included (aOR 1.40; 95% CI, 1.12-1.73). Only procedures targeting the bones and digestive organs were associated with the development of GBS (aOR 2.78; 95% CI, 1.68-4.60 and aOR 2.36; 95% CI, 1.32-4.21, respectively).

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The inability to confirm cases of GBS by chart review represented the main limitation of this study, the researchers noted.

The researchers also added that additional “research is needed to elucidate the mechanisms by which surgery may increase the risk [for] GBS.”


Rudant J, Dupont A, Mikaeloff Y, Bolgert F, Coste J, Weill A. Surgery and risk of Guillain-Barré syndrome: A French nationwide epidemiologic study. Neurology. 2018;91:e1220-e1227.