PT - JOURNAL ARTICLE AU - Hocker, Sara AU - Nagarajan, Elanagan AU - Rubin, Mark AU - Wijdicks, Eelco F.M. TI - Clinical factors associated with Guillain-Barré syndrome following surgery AID - 10.1212/CPJ.0000000000000451 DP - 2018 Jun 01 TA - Neurology: Clinical Practice PG - 201--206 VI - 8 IP - 3 4099 - http://cp.neurology.org/content/8/3/201.short 4100 - http://cp.neurology.org/content/8/3/201.full AB - Background We sought to identify clinical associations and potential triggers of Guillain-Barré syndrome (GBS) within 6 weeks of surgery.Methods We 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.Results A 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.Conclusions Surgery 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.