Objective:

Characterize the real-world, 12-month all-cause mortality among individuals with GBS requiring hospitalization in the United States.

Background:

GBS is associated with a substantial mortality burden, occurring not only during initial hospitalization but also for years afterward. Real-world data quantifying this burden remain limited.

Design/Methods:

This study used a claims database of the commercially insured (“Commercial”) and Medicare FFS 5% Standard Analytic Files (“Medicare”) covering 2017–2023. Eligible patients were required to have GBS diagnosed (ICD-10-CM G61.0), be hospitalized for ≥3 days, and have either a neurological test or treatment (immunoglobulin and/or plasmapheresis) on an inpatient claim. Annual incidence rates were estimated and projected to the 2025 US populations aged ≥65 and <65 years. Mortality rates during the 12 months post-GBS diagnosis were reported.

Results:

Of the estimated 8,039 [95% CI: 7,734–8,364] GBS cases annually, about 1/3 were aged ≥65. The all-age annual incidence rate was 2.39 [2.28–2.47] per 100,000 persons. The incidence rate was 2-fold higher in age ≥65 (4.17 [3.71–4.60]) compared to <65 (1.97 [1.91–2.03]). During index-hospitalization, which lasted mean (SD) 13.3 (11.4) days in Medicare (n=364) and 12.4 days (14.2) in Commercial (n=1,933), 34.9% of Medicare and 28.0% of Commercial received ICU care. The mortality rates during the 12 month-period post-GBS diagnosis including index-hospitalization were 24.0% [19.5–28.6] in Medicare and 5.3% [4.6–5.9] in Commercial. These rates are over 10-fold higher than the annual mortality for a 70-year-old (mean Medicare age), and 16-fold higher for a 45-year-old (mean Commercial age).

Conclusions:

Although GBS is typically regarded as a monophasic illness with a generally favorable prognosis, our findings highlight a significant risk of mortality within the first year following diagnosis, extending beyond the acute hospitalization period. These observations imply that there is an urgent need for more effective acute-stage treatments that can mitigate long-term GBS-associated morbidity and mortality.