The Etiology Analysis of Myasthenia Gravis with In-Hospital Mortality in the Neurocritical Care Unit.

IF 3.6 3区 医学 Q2 CLINICAL NEUROLOGY
Hongxi Chen, Yuan Wang, Nana Zhang, Jie Song, Xue Lin, Chong Yan, Xiao Huan, Ziyan Shi, Xiaofei Wang, Ying Zhang, Qin Du, Lingyao Kong, Dongren Sun, Rui Wang, Ziya Wang, Yangyang Zhang, Jianying Xi, Chongbo Zhao, Hongyu Zhou, Sushan Luo
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Abstract

Background: Our objective was to investigate the characteristics and causes of death in deceased patients with myasthenia gravis (MG).

Methods: This study conducted a retrospective analysis of data from patients with MG in the neurocritical unit at two large general hospitals in China spanning 10 years, from January 2014 to December 2023. Detailed demographic and clinical information were collected for deceased patients. Experienced physicians determined both the underlying and direct causes of death.

Results: Among 3723 patients, the overall hospitalized mortality was 79 (2.12%). Thymoma was present in 52 (65.82%) of these patients. Compared with the nonthymomatous MG (NTMG) group (n = 27), patients with thymomatous MG (TMG) (n = 52) were significantly younger at death (53.71 ± 14.01 years vs. 65.37 ± 14.61 years, p = 0.001). Septic shock was the most common underlying cause of death, affecting 32 (40.51%) patients, followed by myasthenic crisis in 18 (22.78%) patients. This trend was observed in both the TMG and NTMG groups. In the TMG group, fulminant myocarditis was the third leading underlying cause of death in 9 (17.31%) patients, whereas no cases of fulminant myocarditis were reported in the NTMG group. Among all deceased patients (n = 79), pneumonia was the most common infection, affecting 55 (69.62%) patients, followed by urinary tract infections in 14 (17.72%) patients, bloodstream infections in 13 (16.46%) patients, and intracranial infections in 7 (8.86%) patients.

Conclusions: The study suggests that thymoma may increase the risk of death, with septic shock and myasthenic crisis being the most frequent underlying causes in patients with MG.

重症监护病房重症肌无力伴住院死亡率的病因分析。
背景:我们的目的是调查死亡重症肌无力(MG)患者的特征和死亡原因。方法:本研究回顾性分析了2014年1月至2023年12月10年间中国两家大型综合医院神经危重病房MG患者的资料。收集了死亡患者的详细人口统计和临床信息。经验丰富的医生确定了潜在的和直接的死亡原因。结果:3723例患者中,总住院死亡率为79例(2.12%)。其中52例(65.82%)存在胸腺瘤。与非胸腺瘤性MG (NTMG)组(n = 27)相比,胸腺瘤性MG (TMG)组(n = 52)的死亡年龄明显年轻(53.71±14.01岁vs. 65.37±14.61岁,p = 0.001)。感染性休克是最常见的潜在死亡原因,32例(40.51%),其次是肌无力危象18例(22.78%)。在TMG组和NTMG组均观察到这一趋势。在TMG组中,暴发性心肌炎是9例(17.31%)患者死亡的第三大潜在原因,而在NTMG组中没有报告暴发性心肌炎病例。在79例死亡患者中,肺炎是最常见的感染,55例(69.62%),其次是尿路感染14例(17.72%),血流感染13例(16.46%),颅内感染7例(8.86%)。结论:研究表明胸腺瘤可能增加死亡风险,感染性休克和肌无力危象是MG患者最常见的潜在原因。
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来源期刊
Neurocritical Care
Neurocritical Care 医学-临床神经学
CiteScore
7.40
自引率
8.60%
发文量
221
审稿时长
4-8 weeks
期刊介绍: Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.
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