Artikel
Estimation of background incidence rates of Guillain-Barré syndrome in Germany in the years 2007–2009
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Autoren
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S. Hense
- Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen
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T. Schink
- Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen
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E. Garbe
- Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen; Human- und Gesundheitswissenschaften, Universität Bremen, Bremen
| Veröffentlicht: | 4. September 2014 |
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Gliederung
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Background: Guillain-Barré syndrome (GBS) is a peripheral neuropathy which has been implicated as an adverse event following certain vaccines. Age- and sex-specific background incidence rates (IR) of GBS constitute a prerequisite for vaccine safety monitoring, but are not available for Germany. The main objective of this study was to estimate the IR of GBS in Germany in the years 2007–2009. A focus was set on age- and sex-specific IRs as well as on geographic (Western vs. Eastern Germany) and seasonal differences.
Methods: A retrospective cohort study was conducted to estimate the IR of GBS based on claims data from the German Pharmacoepidemiological Research Database (GePaRD) including about 17 million insurants from four German health insurances. Cases of GBS were defined by a main hospital discharge diagnosis of G61.0 (ICD-10-GM) and an inpatient procedure code for lumbar puncture, myography or neurography during the same hospitalization.
Crude as well as standardized IRs (SIR) per 100,000 person years (PY) with 95% confidence intervals (CI) were calculated.
Results: The study population consisted of 13,297,678 insurants, of whom 45.3% were females. The overall SIR was 1.8 (95% CI 1.7-2.0) per 100,000 PY. The SIR of GBS was slightly higher in Western than in Eastern Germany (1.9; 95% CI 1.7-2.0 vs. 1.7; 95% CI 1.4-2.1). With regard to seasonal differences, the highest SIR was seen in spring (2.1; 95% CI 1.8-2.4) while the lowest SIR occurred in autumn (1.6; 95% CI 1.4-1.9). Males had a higher SIR compared to females (2.3; 95% CI 2.1-2.5 vs. 1.5; 95% CI 1.3-1.6). Annual crude IRs increased with age revealing a peak in the age-group 70-79 years (3.9; 95% CI 3.2-4.7).
Discussion: To our knowledge, this is the first study estimating age- and sex-specific IRs of GBS in Germany. The findings were in line with data from other countries, especially regarding age, sex, and seasonal patterns. Our results provide a basis for vaccine safety monitoring in Germany by offering a comparator for observed versus expected analyses for GBS.
