Electrophysiological classification of guillain-barré syndrome: Clinical associations and outcome

BackgroundWe sought to identify clinical associations and potential triggers of Guillain-Barré syndrome (GBS) within 6 weeks of surgery.MethodsWe retrospectively reviewed consecutive patients diagnosed with GBS within 6 weeks of a surgery between January 1995 and June 2014 at Mayo Clinic. Postsurgical GBS was defined as symptom onset within 6 weeks of surgery. Patients with postsurgical GBS were compared with patients who did not have a surgery prior to GBS onset to determine differences between groups.ResultsA total of 208 patients with GBS, median age 55 years (interquartile range [IQR] 41–68), were included. Nineteen patients (9.1%) developed postsurgical GBS. Median duration from the surgery to onset of first GBS symptom was 15 days (IQR 9–37). The main types of surgeries preceding GBS were gastrointestinal, orthopedic, and cardiac. General anesthesia was used in 18 (95%) and conscious sedation in 1 (5%) patient. Among the 19 patients with postsurgical GBS, 11 (57.9%) had a known diagnosis of malignancy. Autoimmune conditions were present in 5 (26.3%) patients. Postoperative infection was found in 4 (21%) patients. On univariate analysis, the factors that showed an association with postsurgical GBS were age (p = 0.02), malignancy (p ≤ 0.0004), active malignancy (p = 0.03), preexisting autoimmune disorder (p = 0.02), and infection (p = 0.0001). On multivariate analysis, only active malignancy (0.03) remained associated.ConclusionsSurgery antedated GBS in 9.1% of patients. Postsurgical GBS was more common in patients with an active malignancy. A prospective study is needed to determine whether active malignancy represents an independent risk factor for the development of postsurgical GBS.

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Use of the International Classification of Functioning, Disability and Health to identify preliminary comprehensive and brief core sets for Guillain Barre syndrome

Disability and Rehabilitation ◽

10.3109/09638288.2010.527031 ◽

2011 ◽

Vol 33 (15-16) ◽

pp. 1306-1313 ◽

Cited By ~ 6

Author(s):

Fary Khan ◽

Julie F. Pallant

Keyword(s):

International Classification ◽

Guillain Barre Syndrome ◽

International Classification Of Functioning ◽

Disability And Health ◽

Guillain Barré Syndrome ◽

Core Sets ◽

Guillain Barré

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The contribution of the Vaccine adverse event Text Mining system to the classification of possible Guillain-Barré Syndrome reports

Applied Clinical Informatics ◽

10.4338/aci-2012-11-ra-0049 ◽

2013 ◽

Vol 04 (01) ◽

pp. 88-99 ◽

Cited By ~ 9

Author(s):

E. J. Woo ◽

R. Ball ◽

T. Botsis

Keyword(s):

Adverse Event ◽

Text Mining ◽

Guillain Barre Syndrome ◽

Specific Information ◽

Diagnostic Features ◽

Mining System ◽

Guillain Barré Syndrome ◽

Guillain Barré ◽

Text Mining System

Summary Background: We previously demonstrated that a general purpose text mining system, the Vaccine adverse event Text Mining (VaeTM) system, could be used to automatically classify reports of anaphylaxis for post-marketing safety surveillance of vaccines. Objective: To evaluate the ability of VaeTM to classify reports to the Vaccine Adverse Event Reporting System (VAERS) of possible Guillain-Barré Syndrome (GBS). Methods: We used VaeTM to extract the key diagnostic features from the text of reports in VAERS. Then, we applied the Brighton Collaboration (BC) case definition for GBS, and an information retrieval strategy (i.e. the vector space model) to quantify the specific information that is included in the key features extracted by VaeTM and compared it with the encoded information that is already stored in VAERS as Medical Dictionary for Regulatory Activities (MedDRA) Preferred Terms (PTs). We also evaluated the contribution of the primary (diagnosis and cause of death) and secondary (second level diagnosis and symptoms) diagnostic VaeTM-based features to the total VaeTM-based information. Results: MedDRA captured more information and better supported the classification of reports for GBS than VaeTM (AUC: 0.904 vs. 0.777); the lower performance of VaeTM is likely due to the lack of extraction by VaeTM of specific laboratory results that are included in the BC criteria for GBS. On the other hand, the VaeTM-based classification exhibited greater specificity than the MedDRA-based approach (94.96% vs. 87.65%). Most of the VaeTM-based information was contained in the secondary diagnostic features. Conclusion: For GBS, clinical signs and symptoms alone are not sufficient to match MedDRA coding for purposes of case classification, but are preferred if specificity is the priority. Citation: Botsis T, Woo EJ, Ball R. The contribution of the vaccine adverse event text mining system to the classification of possible Guillain-Barré syndrome reports. Appl Clin Inf 2013; 4: 88–99http://dx.doi.org/10.4338/ACI-2012-11-RA-0049

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