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Nationwide study of therapeutic plasma exchange vs intravenous immunoglobulin in Guillain‐Barré syndrome
Author(s) -
Beydoun Hind A.,
Beydoun May A.,
Hossain Sharmin,
Zonderman Alan B.,
Eid Shaker M.
Publication year - 2020
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26831
Subject(s) - propensity score matching , medicine , confounding , guillain barre syndrome , retrospective cohort study , odds ratio , logistic regression , pediatrics
Background We compared outcomes of therapeutic plasma exchange (TPE) vs intravenous immunoglobulin (IVIG) among hospitalized patients diagnosed with Guillain‐Barré syndrome (GBS). Methods In a retrospective cohort study of 6642 records (2637 TPE and 4005 IVIG) from the 2002–2014 Nationwide Inpatient Sample, treatment type was examined as predictor of length of stay, total charges, and in‐hospital death, with regression modeling using risk adjustment and propensity scoring to control for confounders. Results Compared with those receiving IVIG, patients who underwent TPE experienced prolonged hospitalization by approximately 7.5 days, greater hospitalization costs by approximately $46,000, and increased in‐hospital death with an odds ratio of 2.78. Results did not change after controlling for confounders through risk adjustment, propensity score adjustment, or matching. Conclusions TPE may be associated with poorer healthcare utilization outcomes vs IVIG, although confounding by indication could not be ascertained.