title: Increased incidence of Guillain-Barré syndrome after surgery.
abstract: OBJECTIVE
  Antecedent surgery has been described to trigger Guillain-Barré syndrome (GBS), but its evidence is poor and based on case reports only.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Surgery must be considered to be a potential risk factor for developing GBS.
authors.affiliation: Department of Neurology, University Hospital Basel, Basel, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Gensicke
authors.forename: A N
authors.initials: AN
authors.lastname: Datta
authors.forename: P
authors.initials: P
authors.lastname: Dill
authors.forename: C
authors.initials: C
authors.lastname: Schindler
authors.forename: D
authors.initials: D
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007239:Infections / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015985:Precipitating Factors; D012189:Retrospective Studies; D012306:Risk; D014611:Vaccination / Q000009:adverse effects