Socioeconomic and Racial Disparities in Guillain-Barré Syndrome Outcomes
Yagiz Altun1, Edward Bader2, Siyu Yan1, Lauren Gluck3
1Department of Neurology, 2Department of Neurological Surgery, Albert Einstein College of Medicine, 3Department of Neurology, Montefiore Medical Center
Objective:
Assess the impact of socioeconomic and racial factors on outcomes in Guillain- Barré Syndrome (GBS).
Background:
GBS is an acute inflammatory demyelinating polyradiculoneuropathy with potentially severe outcomes. However, the impact of socioeconomic and racial factors has not been previously investigated. 
Design/Methods:
We analyzed inpatients from the National Inpatient Sample from 2016-2021. Multivariable logistic regression models were constructed to assess the association between socioeconomic and demographic factors and three outcomes: in-hospital mortality, non-routine discharge, and prolonged hospitalization (length of stay >14 days). All models adjusted for a broad range of covariates including age, sex, and Elixhauser comorbidities. 
Results:

A total of 55,900 hospitalizations with a primary diagnosis of GBS were included. After adjusting for covariates, multivariable logistic regression models revealed several key associations between socioeconomic and racial factors and GBS outcomes:

  1. Individuals from the wealthiest ZIP codes had lower odds of in-hospital mortality (OR 0.57 95% CI [0.35 – 0.95] p = 0.029).
  2. Medicare and Medicaid beneficiaries had higher odds of non-routine discharges (OR 1.50 95% CI [1.31 – 1.72] p < 0.001, and OR 1.21 95% CI [1.07 – 1.38] p = 0.004, respectively).
  3. Black patients had higher odds of non-routine discharge (OR 1.28 95% CI [1.08 – 1.52] p = 0.004).
  4. Hispanic patients had increased odds of prolonged hospitalization OR (1.19 95% CI [1.02 – 1.38] p = 0.028).
  5. Medicaid beneficiaries and self-pay patients had increased odds of prolonged hospitalization (OR 1.46 95% CI [1.27 – 1.69] p <0.001, and OR 1.32 95% CI [1.05 – 1.66] p = 0.016, respectively). 
Conclusions:

This study highlights important socioeconomic and racial disparities in GBS. These findings underscore the need for targeted interventions and policy changes to address healthcare disparities in GBS management.

10.1212/WNL.0000000000208994
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