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Hyponatremia in Guillain–Barré Syndrome

Rumalla, Kavelin*; Reddy, Adithi Y.*; Letchuman, Vijay*; Mittal, Manoj K. MD

Journal of Clinical Neuromuscular Disease: June 2017 - Volume 18 - Issue 4 - p 207–217
doi: 10.1097/CND.0000000000000157
Original Article

Objectives: To evaluate incidence, risk factors, and in-hospital outcomes associated with hyponatremia in patients hospitalized for Guillain–Barré Syndrome (GBS).

Methods: We identified adult patients with GBS in the Nationwide Inpatient Sample (2002–2011). Univariate and multivariable analyses were used.

Results: Among 54,778 patients hospitalized for GBS, the incidence of hyponatremia was 11.8% (compared with 4.0% in non-GBS patients) and increased from 6.9% in 2002 to 13.5% in 2011 (P < 0.0001). Risk factors associated with hyponatremia in multivariable analysis included advanced age, deficiency anemia, alcohol abuse, hypertension, and intravenous immunoglobulin (all P < 0.0001). Hyponatremia was associated with prolonged length of stay (16.07 vs. 10.41, days), increased costs (54,001 vs. 34,125, $USD), and mortality (20.5% vs. 11.6%) (all P < 0.0001). In multivariable analysis, hyponatremia was independently associated with adverse discharge disposition (odds ratio: 2.07, 95% confidence interval, 1.91–2.25, P < 0.0001).

Conclusions: Hyponatremia is prevalent in GBS and is detrimental to patient-centered outcomes and health care costs. Sodium levels should be carefully monitored in high-risk patients.

*School of Medicine, University of Missouri, Kansas City, MO; and

Department of Neurology, University of Kansas Medical Center, Kansas City, KS.

Reprints: Kavelin Rumalla, School of Medicine, University of Missouri, 2411 Holmes St, Kansas City, MO 64108 (e-mail:

The authors report no conflicts of interest.

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