Increased incidence of Guillain-Barré syndrome after surgery

Antecedent surgery has been described to trigger Guillain-Barré syndrome (GBS), but its evidence is poor and based on case reports only.

We performed a retrospective analysis of 63 patients with GBS admitted to the University Hospital Basel and University Children's Hospital Basel from January 2005 to December 2010. We calculated and compared the incidences of post-surgical and non-exposed patients with GBS in the study population and those reported previously in literature.

Six of 63 (9.5%) GBS cases had had a surgery within 6 weeks prior to GBS. The relative risk of developing GBS during the 6-week period after surgery is 13.1 times higher than the normal incidence in the study population (95% confidence interval: 5.68, 30.3; P ≤ 0.0001), suggesting an attributable risk of 4.1 cases per 100, 000 surgeries. In addition, the incidence of post-surgical GBS is significantly higher than influenza vaccine-associated GBS in the study population (P = 0.01) as well as in comparison with previous reported vaccine-associated GBS (P ≤ 0.0001) and background incidences (P ≤ 0.0001).

Surgery must be considered to be a potential risk factor for developing GBS.