Vanderbilt University Medical Center, Department of Neurology, 1161 21st Avenue South, MCN A0118, Nashville, Tennessee 37232, USA.
Muscle Nerve. 2012 Jul;46(1):60-2. doi: 10.1002/mus.23261. Epub 2012 May 29.
Precise causes and risk factors for Guillain-Barré syndrome (GBS) remain incompletely understood, and monitoring its incidence remains important in public health. Active surveillance is not sustainable, but hospital discharge databases (HDDs) may be suitable for passive surveillance.
We optimized Tennessee's HDD of all ICD-9 codes of 357.0, from 2000 to 2010. Discharges for persons with a GBS diagnosis in a previous hospitalization in the database were excluded. HDD results were compared with the CDC's active surveillance program during the H1N1 vaccination program of 2009-2010.
Of 2,659 records of Tennessee residents initially identified, 1077 (40%) had prior diagnoses of GBS. Adjusted annual rates ranged from 1.24 to 1.57 per 100,000 population. The sensitivity of the optimized HDD was 0.81 with a positive predictive value of 0.45.
Optimization of a HDD through exclusion of nonacute cases results in an acceptable and practical database for passive surveillance of GBS.
吉兰-巴雷综合征（GBS）的确切病因和危险因素仍不完全清楚，因此监测其发病率在公共卫生中仍然很重要。主动监测是不可持续的，但医院出院数据库（HDD）可能适合被动监测。
我们优化了田纳西州 2000 年至 2010 年所有 ICD-9 代码 357.0 的 HDD。排除数据库中以前住院诊断为 GBS 的患者的出院记录。HDD 结果与 2009-2010 年 H1N1 疫苗接种计划期间疾病预防控制中心的主动监测计划进行了比较。
在最初确定的 2659 名田纳西州居民的记录中，有 1077 名（40%）有先前的 GBS 诊断。调整后的年发病率范围为每 100,000 人 1.24 至 1.57 人。优化后的 HDD 的灵敏度为 0.81，阳性预测值为 0.45。
通过排除非急性病例来优化 HDD，可以为 GBS 的被动监测提供一个可接受且实用的数据库。
