{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T15:47:15Z","timestamp":1767887235969,"version":"3.49.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To determine the patterns of hospital utilization of plasma exchange (PE), intravenous immunoglobulin (IVIG), or combination therapy in Guillain-Barr\u00e9 syndrome in a large US cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Guillain-Barr\u00e9 syndrome patients, older than 18 years, were identified from the Nationwide Inpatient Sample database for the years 2000 through 2005. Patients with documented immunotherapy during hospitalization were included. We used the Cochran-Armitage test to assess the trend of hospital utilization of the type of immune intervention over time. Binomial logistic regression model was used to identify the association between patient and hospital demographics and hospital- associated complications with the type of therapy administered during hospitalization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>After data cleansing, 1657 patients were included. There is a decreasing trend in PE utilization and an increasing trend in IVIG use over the 6 years included in this study (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). Patients who received PE were older (mean age of 50.8 \u00b1 18.5 versus 42.2 \u00b1 24.2, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) and had higher complication rates including respiratory failure (18.9% versus 7.56%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) and sepsis (2.85% versus 0.61%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.003). In addition, the mortality rate is lower in the group treated with IVIG when compared with PE (0.45% versus 3.3%, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). Conversely, 61% of patients treated with IVIG group were discharged to home compared with 42% of patients treated with PE.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The trend analysis supports an increasing use of IVIG over PE. Older population and those with pulmonary or sepsis complications were likely treated with PE. The mortality rate was higher in patients treated with PE.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/cnd.0b013e318182b5ce","type":"journal-article","created":{"date-parts":[[2008,9,1]],"date-time":"2008-09-01T07:08:02Z","timestamp":1220252882000},"page":"4-10","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Immunotherapy for Guillain-Barr\u00e9 Syndrome in the US Hospitals"],"prefix":"10.1097","volume":"10","author":[{"given":"Amer","family":"Alshekhlee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zulfiqar","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badr","family":"Sultan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bashar","family":"Katirji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-2-20240808","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/S0140-6736(78)91837-8","article-title":"Treatment of acute polyneuropathy by plasma exchange.","volume":"2","author":"Brettle","year":"1978","journal-title":"Lancet"},{"key":"R2-2-20240808","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1212\/WNL.38.10.1639","article-title":"Treatment of Guillain-Barre syndrome with high dose gammaglobulin.","volume":"38","author":"Kleyweg","year":"1988","journal-title":"Neurology"},{"key":"R3-2-20240808","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1212\/WNL.35.8.1096","article-title":"Plasmapheresis and acute Guillain-Barre syndrome.","volume":"35","year":"1985","journal-title":"Neurology"},{"key":"R4-2-20240808","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1056\/NEJM199204233261705","article-title":"A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barre syndrome.","volume":"326","author":"Van der Meche","year":"1992","journal-title":"N Engl J Med"},{"key":"R5-2-20240808","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/ana.410320115","article-title":"Plasma exchange in Guillain-Barre syndrome: one-year follow-up.","volume":"32","year":"1992","journal-title":"Ann Neurol"},{"key":"R6-2-20240808","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S0140-6736(96)09095-2","article-title":"Randomized trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barre syndrome.","volume":"349","year":"1997","journal-title":"Lancet"},{"key":"R7-2-20240808","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1212\/01.wnl.0000310983.38724.d4","article-title":"Guillain-Barre syndrome: incidence and mortality rates in US hospitals.","volume":"70","author":"Alshekhlee","year":"2008","journal-title":"Neurology"},{"key":"R8-2-20240808","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1212\/01.wnl.0000218306.35681.38","article-title":"Mortality of stroke patients treated with thrombolysis: analysis of nationwide inpatient sample.","volume":"66","author":"Dubinsky","year":"2006","journal-title":"Neurology"},{"key":"R9-2-20240808","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"R10-2-20240808","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1212\/WNL.52.3.635","article-title":"Fatal Guillain-Barre syndrome.","volume":"52","author":"Lawn","year":"1999","journal-title":"Neurology"},{"key":"R11-2-20240808","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.1212\/WNL.54.12.2311","article-title":"Long-term outcome in patients with Guillain-Barre syndrome requiring mechanical ventilation.","volume":"54","author":"Fletcher","year":"2000","journal-title":"Neurology"},{"key":"R12-2-20240808","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1002\/ana.410220612","article-title":"Efficiency of plasma exchange in Guillain-Barre syndrome: role of replacement fluids.","volume":"22","year":"1987","journal-title":"Ann Neurol"},{"key":"R13-2-20240808","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1093\/brain\/awm004","article-title":"Immunotherapy for Guillain-Barre syndrome: a systematic review.","volume":"130","author":"Hughes","year":"2007","journal-title":"Brain"},{"key":"R14-2-20240808","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1212\/WNL.61.6.736","article-title":"Practice parameter: immunotherapy for Guillain-Barre syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology.","volume":"61","author":"Hughes","year":"2003","journal-title":"Neurology"}],"container-title":["Journal of Clinical 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