IVIg Versus Plasmapheresis Outcomes and Costs in Patients Diagnosed with Guillian-Barre Syndrome(2009-2013). A New York Statewide Planning and Research Cooperation System (SPARCS) Database Report (P2.273)

Objective: Comparing outcomes and costs between Guillian-Barre Syndrome (GBS) treatment modalities: Plasmapheresis vs intravenous immunoglobulin (IVIg) Background: GBS is usually treated with Immunoglobulines (IVIg) and Plasmapheresis. Methods: TheNew York Statewide Planning and Research Cooperation System (SPARCS) database was utilized, we selected adults admitted for GBS for 2009-2013. Patients were divided into Plasmapheresis and IVIg arms and analyzed by Chi-square test and Wilcoxon rank-sum test Results: A total 1027 patients were analyzed 822 receiving IVIg and 205 plasmapheresis, median age was 56 years and 55[percnt] were males. The IVIg group fared better overall versus the plasmapheresis group, with more home discharges (35[percnt] vs 18[percnt]) and decreased mortality (1[percnt] vs 2[percnt]) (improved discharge status, p=0.001). IVIg group also had decreased length of stay with a median of 7 days vs 14(p=0.017), less reported intrahospitalary infections with 19[percnt] vs 26[percnt] (p=0.027). Additionally, IVIg patients necessitated both less instances of endotracheal intubation as well as spent less time on mechanical ventilation with 2[percnt] requiring 96 hours of mechanical ventilation respectively (p=0.001). There was no significant difference in readmissions or multiple readmissions between both groups (p=0.838). Furthermore, there was a significant decrease in average hospitalization costs and charges over 5 years with an average of $115,950 for IVIg patients vs $158,000 for those receiving plasmapheresis (p=0.001) Conclusions: IVIg performed significantly better than plasmapheresis in all our metrics, with the exception of readmissions, with improved outcomes and at a reduced cost. Work is in progess to assess whether or not other factors are contributing to this outcome difference such as patient type of insurance and socieconomic status, facility location and affiliation ( ruralversus urban, academic versus community) and whether severe GBS are preferentially treated with plasmapheresis. Disclosure: Dr. El-Ghanem has nothing to disclose. Dr. Gomez has nothing to disclose. Dr. Nasar has nothing to disclose. Dr. Souayah has received personal compensation for activities Grifols as a consultant and/or speakers bureau participant.