Real-world hospitalization and readmission trajectory after Guillain-Barré syndrome in the United States

Abstract Background Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy associated with substantial morbidity, but contemporary data on post-discharge readmission remain limited. We characterized 90-day readmission timing, causes, associated factors, and procedure coding after GBS. Methods We analyzed an unweighted cohort of adults with a principal diagnosis of GBS in the 2020 Nationwide Readmissions Database. The primary outcome was all-cause readmission within 90 days after discharge. Readmission causes were classified using principal readmission diagnoses mapped to Clinical Classifications Software Refined categories, and procedure coding was descriptively assessed using ICD-10 procedure codes and procedure-day variables. Logistic regression models were used to identify factors associated with readmission. Results Among 2,587 adults eligible for 90-day follow-up, 364 (14.1%) were readmitted. Readmissions clustered early, with 170 (46.7%) occurring within 15 days and 241 (66.2%) within 30 days. Separately, GBS was the principal diagnosis in 170 of 364 readmissions (46.7%), representing the largest grouped cause followed by septicemia (9.6%) and cardiovascular or thromboembolic conditions (6.9%). In adjusted analyses, discharge disposition was the most consistent marker of readmission risk: compared with routine home discharge, facility discharge was associated with higher odds of 90-day readmission (odds ratio 1.70, 95% confidence interval 1.27–2.28). Procedure-code timing suggested that diagnostic evaluation and immunotherapy were administered early, whereas plasma exchange, tracheostomy, gastrostomy, and rehabilitation-related procedures were performed at later stages. Conclusions Readmission after GBS is frequent, early, and clinically heterogeneous, supporting its interpretation as a marker of residual neurological disability, systemic complications, and care-transition vulnerability rather than recurrent GBS alone.