Mortality in myasthenia gravis: A nationwide population–based follow‐up study in Denmark

Hansen, Julie Schjødtz; Danielsen, Ditte H.; Somnier, Finn E.; Frøslev, Trine; Jakobsen, Johannes; Johnsen, Søren P; Andersen, Henning

doi:10.1002/mus.24697

Cited by 45 publications

(44 citation statements)

References 28 publications

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“…Age and gender impacts on myasthenia gravis mortality have been controversial [22,23,31,32]. In our study, we found the incidence of postoperative complications lower in male and elderly patients than in females and other age groups.…”

Section: Discussionsupporting

confidence: 47%

“…In our study, we found the incidence of postoperative complications lower in male and elderly patients than in females and other age groups. Similarly, a 2015 nationwide population-based study in Denmark enrolled 702 AChR-Ab-seropositive myasthenia gravis patients and found myasthenia gravis mortality rates were higher in women and early-onset myasthenia gravis, perhaps due to increased frequency of combined autoimmune disorders and thymoma in these patients [22,31,32]. Although mortality and postoperative complications differ, these groups of patients could be followed with greater care after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, the incidence of postoperative adverse events was higher in patients without medical conditions than in the other two groups. This could be because fewer comorbidities in early-onset myasthenia gravis patients still yield higher mortality [31], or other coexisting medical conditions’ impacts being eliminated by propensity score-matching procedure.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study

et al. 2017

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ObjectiveTo validate the comprehensive features of adverse outcomes after surgery for patients with myasthenia gravis.MethodsUsing reimbursement claims from Taiwan’s National Health Insurance Research Database, we analyzed 2290 patients who received major surgery between 2004 and 2010 and were diagnosed with myasthenia gravis preoperatively. Surgical patients without myasthenia gravis (n = 22,900) were randomly selected by matching procedure with propensity score for comparison. The adjusted odds ratios and 95% confidence intervals of postoperative adverse events associated with preoperative myasthenia gravis were calculated under the multiple logistic regressions.ResultsCompared with surgical patients without myasthenia gravis, surgical patients with myasthenia gravis had higher risks of postoperative pneumonia (OR = 2.09; 95% CI: 1.65–2.65), septicemia (OR = 1.31; 95% CI: 1.05–1.64), postoperative bleeding (OR = 1.71; 95% CI: 1.07–2.72), and overall complications (OR = 1.70; 95% CI: 1.44–2.00). The ORs of postoperative adverse events for patients with myasthenia gravis who had symptomatic therapy, chronic immunotherapy, and short-term immunotherapy were 1.76 (95% CI 1.50–2.08), 1.70 (95% CI 1.36–2.11), and 4.36 (95% CI 2.11–9.04), respectively.ConclusionsPatients with myasthenia gravis had increased risks of postoperative adverse events, particularly those experiencing emergency care, hospitalization, and thymectomy for care of myasthenia gravis. Our findings suggest the urgency of revising protocols for perioperative care for these populations.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study

et al. 2017

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“…Estos signos, explorados en forma aislada, desvían la atención y pueden confundirse con crisis asmática (27,28) por lo cual se debe realizar anamnesis exahustivas. El electromiograma de fibra única (SFEMG), es un examen útil para diagnosticar la enfermedad, y tiene alta especificidad y sensibilidad en pacientes con anticuerpos positivos, la prueba con inhibidores de la colinesterasa como el Edrofonio tiene alta sensibilidad en pacientes con anticuerpos a AchR, no observándose lo mismo en pacientes con anti-Musk (1) (7,8), por las condiciones al ingreso de la paciente y teniendo los resultados de anticuerpos a AchR positivos , no se realizaron estas pruebas en la paciente; pero si utilizamos la prueba del hielo que fue positiva, ésta se trata de una prueba simple y eficaz, que consiste en colocar un recipiente de hielo sobre los párpados cerrados del paciente durante un período de 2 minutos para ptosis y 5 minutos para oftalmoparesia . Los déficits de motilidad ocular y la apertura palpebral deben medirse antes y después de la prueba.…”

Section: Discussionunclassified

Miastenia gravis de tipo bulbar en niños: un caso de difícil diagnóstico.

Alvarado-Merino¹,

Espíritu²,

Juárez³

et al. 2017

Rev Neuropsiquiatr

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La miastenia gravis (MG) es un trastorno autoinmune caracterizado por debilidad y fatigabilidad de los músculos esqueléticos debida a la disfunción de la unión neuromuscular. Se presenta el caso de una adolescente de 11 años de edad, con diagnóstico de miastenia gravis de tipo bulbar. La paciente presentó dos crisis de MG previamente diagnosticadas de manera equivocada como crisis asmáticas. Recibió tratamiento con inmunoglobulina humana, corticoides, piridostigmina y timectomía. Se discute la evolución clínica y riesgos atribuibles a situaciones sociales que pueden retrasar el diagnóstico y su manejo efectivo.

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“…The reported incidence of MG has markedly varied across epidemiological studies, and the pooled annual incidence of MG was calculated to be 5.3 per million persons based on 55 population-based epidemiological studies [3]. Notably, MG diagnosis is associated with increased risk of mortality [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of the TCM Qi‐Supplementing Therapy in Patients with Myasthenia Gravis: A Systematic Review and Meta‐Analysis

Yang

Liu

Yang

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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Background The Traditional Chinese Medicine (TCM) Qi-supplementing therapy has been used widely for treating myasthenia gravis (MG) in China. The purpose of this meta-analysis was to evaluate the efficacy and safety of Qi-supplementing therapy as an adjunctive therapy in MG patients. Methods Seven electronic databases were searched through June 2016. Randomized controlled trials (RCTs) evaluating the add-on effect of Qi-supplementing therapy in MG patients were included. The outcome measures were the total effective rate, relapse rate, and adverse events. Results Twenty-three RCTs involving 1,691 MG patients were included. The included studies were of low-to-moderate quality. Meta-analysis showed that Qi-supplementing therapy combined with Western medicine (WM) significantly improved the total response rate and reduced the relapse risk during 6–24 months of follow-up. Subgroup analysis showed that Qi-supplementing therapy only affected the total response rate within the first 6 months of treatment. Moreover, the rate of adverse events was lower with the addition of Qi-supplementing therapy to WM than with WM only. Conclusions Short-term Qi-supplementing therapy combined with WM appears to be superior to WM for improving the total response rate and reducing the relapse rate. However, more high-quality RCTs are warranted owing to methodological flaws of previous trials.

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Mortality in myasthenia gravis: A nationwide population–based follow‐up study in Denmark

Abstract: MG diagnosis is still associated with increased mortality.

Cited by 45 publications

References 28 publications

Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study

Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study

Miastenia gravis de tipo bulbar en niños: un caso de difícil diagnóstico.

Efficacy and Safety of the TCM Qi‐Supplementing Therapy in Patients with Myasthenia Gravis: A Systematic Review and Meta‐Analysis

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