title: Coexisting infectious diseases on admission as a risk factor for mechanical ventilation in patients with Guillain-Barré syndrome.
abstract: BACKGROUND
  The aim of this study was to investigate patient characteristics on admission to hospital that increase the risk of subsequent mechanical ventilation (MV) use for patients with Guillain-Barré syndrome (GBS).
  
  
  METHODS
  We extracted data from the Japanese Diagnosis Procedure Combination (DPC) database for 4132 GBS patients admitted to hospital. Clinical characteristics of GBS patients with and without MV were compared. Multivariate logistic regression analyses were performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of requirement for MV with coexisting infectious diseases, after adjustment for potential confounding variables, age, sex, hospital type, and ambulance transportation.
  
  
  RESULTS
  In total, 281 patients required MV, and 493 patients had coexisting respiratory diseases on admission. After adjustment for covariates and stratification by coexisting respiratory diseases, multivariate logistic regression analysis revealed that coexisting cytomegaloviral (CMV) disease (OR 8.81; 95% CI, 2.34-33.1) and herpes simplex viral (HSV) infections (OR 4.83; 95% CI, 1.16-20.1) were significantly associated with the requirement for MV in the group without coexisting respiratory diseases.
  
  
  CONCLUSIONS
  Our findings suggest that coexisting CMV and HSV infections on admission might be significantly associated with increased risk of respiratory failure in GBS patients.
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan; Department of Occupational Health Data Science Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. Electronic address: skobori@med.uoeh-u.ac.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kobori
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Occupational Health Data Science Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Otani
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Muramatsu
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujino
authors.affiliation: Department of Neurology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.affiliation: Department of Health Policy and Informatics, Tokyo Medical and Dental University, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D060085:Coinfection; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D006561:Herpes Simplex / Q000150:complications*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010343:Patient Admission; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012307:Risk Factors
keywords: Coexisting infectious diseases; Guillain–Barré syndrome; Mechanical ventilation