Title Analysis of influencing factors of postoperative myasthenic crisis in 564 patients with myasthenia gravis in a single center
Authors Jiao, Peng
Wu, Fanjuan
Liu, Yuxing
Wu, Jiangyu
Sun, Yaoguang
Tian, Wenxin
Yu, Hanbo
Huang, Chuan
Li, Donghang
Wu, Qingjun
Ma, Chao
Tong, Hongfeng
Affiliation Chinese Acad Med Sci, Beijing Hosp, Inst Geriatr Med, Natl Ctr Gerontol,Dept Thorac Surg, Beijing, Peoples R China
Peking Univ, Dept Med, Beijing, Peoples R China
Keywords PROGNOSTIC-FACTORS
CLINICAL-FEATURES
PREDICTIVE SCORE
THYMECTOMY
DISEASE
Issue Date Jan-2023
Publisher THORACIC CANCER
Abstract Objective: To study the influencing factors of myasthenic crisis in patients with myasthenia gravis during perioperative period.Methods: A total of 564 myasthenia gravis (MG) patients who underwent standard expanded resection of thymoma/thymoma in the Department of Thoracic Surgery of Beijing Hospital from January 2011 to March 2022 were retrospectively included in the study. Clinical indicators such as gender, age, thymoma, American Society of Anesthesiologists (ASA) score, operation time, intraoperative blood loss, and some others were recorded.Results: Osserman-stages IIB + III + IV (odds ratio [OR] 16.091, 95% confidence interval [CI] 5.170-50.076, p value < 0.001), the dosage of pyridostigmine bromide more than 240 mg (OR 6.462, 95% CI 3.110-13.427, p value < 0.001), ASA score 2 and 3 (OR 3.203, 95% CI 1.461-7.020, p value = 0.004), low diffusion lung capacity for carbon monoxide (DLCO%) (OR 0.981, 95% CI 0.963-1.000 p value = 0.049), and blood loss greater than 1000 ml (OR 16.590, 95% CI 1.911-144.011, p value = 0.011) were independent risk factors for myasthenic crisis.Conclusions: Patients with poor Osserman stages, higher preoperative dosage of pyridostigmine bromide, higher ASA score, poor pulmonary function (low DLCO%), and more intraoperative bleeding should be highly vigilant for the occurrence of postoperative myasthenic crisis.
URI http://hdl.handle.net/20.500.11897/668116
ISSN 1759-7706
DOI 10.1111/1759-7714.14774
Indexed SCI(E)
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