Abstract
In order to describe the incidence of Guillain-Barré syndrome (GBS) in Stockholm County (SC) and hospital use by GBS patients, we conducted a retrospective epidemiological study on GBS covering 1973--1991, using the Hospital In-patient Register in SC. There were 556 patients, bona fide residents in the county during the study period, discharged from hospitals with GBS diagnosis. The mean annual incidence, age-adjusted to the European population, was 1.84 (2.15 for males and 1.57 for females) per 100,000 population. The incidence increased with age and showed a bimodal distribution with peaks in the 10--29 and 70--79 age-groups. Annual incidence rates were highest in 1978 and 1983. Neither heterogeneity of annual or monthly rates nor linear trends during the period were found to be significant, except in 1978 for patients below 40 years of age, RR 1.72 (95% CI 1.08--2.71) and in 1983 for patients at ages 40 years and over, RR 1.48 (95% CI 1.02--2.16), when compared with GBS incidences in the same age-groups during the remaining study period. The mean ± SD duration of hospital stay, including long-term care or rehabilitation institutions, for GBS patients, was 86 ± 210 days, with considerably longer duration for the elderly. The rate of hospital use by GBS patients was 162 days per 100,000 inhabitants per year. In accordance with results of prior studies in South-West Stockholm and described GBS epidemics in Sweden, this study supports that an etiologically different subgroup of GBS exists at ages below 40 years, and that relevant but small time-space variations, such as the reported zimeldine epidemic in 1983, resist detection by hospital data analysis of pooled GBS cases. Efficient epidemiological surveillance of GBS may require targeted development of clinicoepidemiological tools.
Similar content being viewed by others
References
Alter M. The epidemiology of Guillain-Barré syndrome. Ann Neurol 1990; 27(suppl): S7–S12.
Beghi E, Cornelio F, Marconi M, Rizzuto N, Tonali P, the Plasmapheresis Study Group. The epidemiology of inflammatory polyradiculoneuropathy: A critical review of the distribution, characteristics and outcome of the disease. Ital J Neurol Sci 1991; 12: 63–73.
Langmuir AD. Guillain-Barré syndrome: The swine influenza virus vaccine incident in the United States of America, 1976–1977; preliminary communication. J R Soc Med 1979; 72: 660–669.
Schonberger LB, Hurwitz ES, Katona P, Holman RC, Bregman DJ. Guillain-Barré syndrome: Its epidemiology and associations with influenza vaccination. Ann Neurol 1981; 9(suppl): 31–38.
Schaumburg HH. Inflammatory polyneuropathy (Guillain-Barré syndrome and related disorders). In: Wyngaarden JB, Smith LH (eds), Cecil Textbook of Medicine, 17th edn. Philadelphia: WB Saunders, 1985: 2190–2191.
Koobatian TJ, Birkhead GS, Schramm MM, Vogt RL. The use of hospital discharge data for public health surveillance of Guillain-Barré syndrome. Ann Neurol 1991; 30: 618–621.
McLean M, Duclos P, Jacob P, Humphreys P. Incidence of Guillain-Barré syndrome in Ontario and Quebec, 1983–1989, using hospital service databases. Epidemiology 1994; 5: 443–448.
Jiang G-X, de Pedro-Cuesta J, Fredrikson S. Guillain-Barré syndrome in South-West Stockholm, 1973–1991, 1. Quality of registered hospital diagnoses and incidence. Acta Neurol Scand 1995; 91: 109–117.
de Pedro-Cuesta J, Abraira V, Jiang G-X, Solders G, Fredrikson S. Guillain-Barré syndrome in South-West Stockholm, 1973–1991, 3. Clinicoepidemiological subgroups. Acta Neurol Scand 1996; 93: 175–183.
Fagius J, Osterman PO, Sidén Å, Wiholm B-E. Guillain-Barré syndrome following zimeldine treatment. J Neurol Neurosurg Psychiatry 1985; 48: 65–69.
HSN — områdesdata 1990 för Stockholms län. Stockholms läns landsting, Regionplane-och trafikkontoret Rapport 1990: 2, Stockholm, 1990: 1–107.
Fenna D, Abrahamsson S, Lööw SO, Peterson H. The Stockholm County Medical Information System. Lecture Notes in Medical Informatics, vol 2. Berlin, Heidelberg, New York: Springer Verlag 1978.
Ahlbom A. Acute myocardial infarction in Stockholm, a medical information system as an epidemiological tool [Dissertation]. Department of Social Medicine, Karolinska Institute, Huddinge, Sweden, 1978.
Allebeck P, Ljungström K, Allander E. Rheumatoid arthritis in a medical information system: How valid is the diagnosis? Scand J Soc Med 1983; 11: 27–32.
Dean AD, Dean JA, Burton AH, Dicker RC. Epi Info, Version 6: A word processing, database, and statistics program for epidemiology on microcomputers. Georgia, USA: USD, Incorporated Stone Mountain, 1990.
Doll R, Cook R. Summarizing indices for comparison of cancer incidence data. Int J Cancer 1967; 2: 269–279.
Schoenberg BS. Calculating confidence intervals for rates and ratios. Neuroepidemiology 1983; 2: 257–265.
Armitage P, Berry G (eds). Statistical methods in medical research, 2nd edn. Oxford: Blackwell Scientific Publications, 1987: 200–213.
Knox EG, Lancashire R. Detection of minimal epidemics. Stat Med 1982; 1: 183–189.
Fisher M. An unusual variant of acute idiopathic polyneuritis (syndrome of ophthalmoplegia, ataxia, and areflexia). N Engl J Med 1956; 255: 57–65.
Paolino E, Govoni V, Tola MR, Casetta I, Granieri E. Incidence of the Guillain-Barré syndrome in Ferrara, Northern Italy, 1981–1987. Neuroepidemiology 1991; 10: 105–111.
Soffer DOV, Feldman S, Alter M. Epidemiology of Guillain-Barré syndrome. Neurology 1978; 28: 686–690.
Hogg JE, Kobrin DE, Schoneberg BS. The Guillain-Barré syndrome epidemiologic and clinical features. J Chron Dis 1979; 32: 227–231.
Bak P. Guillain-Barré syndrome in a Danish county. Neurology 1985; 35: 207–211.
Larsen JP, Kvåle G, Nyland H. Epidemiology of the Guillain-Barré syndrome in the county of Hordaland, Western Norway. Acta Neurol Scand 1985; 71: 43–47.
Kaplan JG, Schonberger LB, Hurwitz ES, Katona P. Guillain-Barré syndrome in the USA, 1978–1981: Additional observations from the national surveillance system. Neurology 1983; 33: 633–637.
Radhakrishnan K, El-Mangoush MA, Gerryo SE. Descriptive epidemiology of selected neuromuscular disorders in Benghazi, Libya. Acta Neurol Scand 1987; 75: 95–100.
Lesser RP, Hauser WA, Kurland LT, Mulder DW. Epidemiologic features of the Guillain-Barré syndrome. Neurology 1973; 23: 1269–1272.
Hankey GJ. Guillain-Barré syndrome in Western Australia, 1980–1985. Med J Austr 1987; 146: 130–133.
Hughes RAC (ed). Guillain-Barré Syndrome. London: Springer Verlag, 1990: 101–119.
McFarlin DE. Immunological parameters in Guillain-Barré syndrome. Ann Neurol 1990; 27(suppl): S25–S29.
Svennerholm L, Fredman P. Antibody detection in Guillain-Barré syndrome. Ann Neurol 1990; 27(suppl): S36–S40.
Boucquey D, Sindic CJM, Lamy M, Delmée M, Tomasi JP, Laterre EC. Clinical and serological studies in a series of 45 patients with Guillain-Barré syndrome. J Neurol Sci 1991; 104: 56–63.
Kaplan JE, Poduska PJ, McIntosh GC, Hopkins RS, Ferguson SW, Schonberger LB. Guillain-Barré syndrome in Larimer County, Colorado: A high-incidence area. Neurology 1985; 35: 581–584.
Winner SJ, Evans JG. Age-specific incidence of Guillain-Barré syndrome in Oxfordshire. Quart J Med 1990; 77: 1297–1304.
Wiholm B-E. Spontaneous reporting of ADR: Fertilization with register data on morbidity and drug utilization. In: Boström H, Larsson T, Ljungstedt A (eds), Drug dependence-Treatment and Treatment Evaluation. Stockholm, Sweden: zAlmqvist & Wiksell International, 1975: 152–167.
Estrada Gonzalez R, Mas R. Virological findings in acute polyradiculoneuritis-LGBS type. Various findings in relation to Coxsackie A4 virus. Neurol Neurocir Psiquiatr 1977; 18(suppl 2–3): 527–231.
Davis LE. Nervous system complications of systemic viral infections. Chapter 34. In: Aminoff MJ (ed), Neurology and General Medicine. New York: Churchill Livingstone, 1989: 599–624.
Beghi E, Nicolosi A, Kurland LT, Mulder DW, Hauser WA, Shuster L. Encephalitis and aseptic meningitis, Olmsted County, Minnesota, 1950–1981: I. Epidemiology. Ann Neurol 1984; 16: 283–294.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jiang, GX., Cheng, Q., Ehrnst, A. et al. Guillain-Barré syndrome in Stockholm County, 1973--1991. Eur J Epidemiol 13, 25–32 (1997). https://doi.org/10.1023/A:1007312112285
Issue Date:
DOI: https://doi.org/10.1023/A:1007312112285