Survival Outcomes of Medicare-Covered Elderly US Population With Myasthenia Gravis.

IF 3.1 3区医学 Q2 CLINICAL NEUROLOGY

Muscle & Nerve Pub Date : 2025-10-17 DOI:10.1002/mus.70045

Yuebing Li, David Bruckman, Jesse D Schold, Benjamin Claytor, Nicholas Silvestri, Michael K Hehir, Ikjae Lee

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引用次数: 0

Abstract

Introduction/aim: Survival outcomes have been inadequately studied among people with myasthenia gravis (MG) in the United States (US). We examined the impact of MG and comorbid conditions on longevity.

Methods: We performed a longitudinal study using Medicare claims data (2006-2019). Incident MG cohort was identified based on the following criteria: age ≥ 65 years; ≥ 1 month of fee-for-service Parts A and B coverage; no health maintenance organization coverage; initial and subsequent MG claims within 2010-2011 separated by ≥ 28 days. A non-MG cohort of five times the number of the MG group was selected, matching for age, sex, region, and Medicare coverage duration. Overall and cause-specific mortality were compared between cohorts in the subsequent 8-10 Years using Kaplan-Meier plots and Cox proportional hazard models, adjusted for the Charlson Comorbidity Index (CCI).

Results: Cohorts of 6024 incident MG and 30,083 control beneficiaries were Included. The mortality rate was higher in the MG cohort compared to controls (66.8 vs. 57.1 per 1000-person-year, p < 0.0001). After adjusting for time-varying CCI, no significant difference in survival was observed between two cohorts (adjusted hazard ratio 1.09 [0.87-1.36], p = 0.47). Sixteen percent of deaths in the MG cohort were attributed to MG. Compared to the non-MG cohort, mortality rates (per 1000-person-year) specific to infections were higher among the MG cohort (2.0 vs. 1.2) while malignancies and dementia-specific mortality rates were lower (10.3 vs. 12.5 and 4.7 vs. 7.2), all p < 0.01.

Discussion: Long-term mortality is increased in elderly MG patients compared to non-MG counterparts, driven by their higher comorbidity burden.

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美国老年重症肌无力患者的生存结局

在美国，重症肌无力（MG）患者的生存结局研究尚不充分。我们研究了MG和合并症对寿命的影响。方法：我们使用医疗保险索赔数据（2006-2019）进行了一项纵向研究。根据以下标准确定事件MG队列：年龄≥65岁；≥1个月的按服务收费的A部和B部保险；没有健康维护组织的保险；2010-2011年首次和后续MG索赔间隔≥28天。选择非MG组人数为MG组人数的五倍的队列，根据年龄、性别、地区和医疗保险覆盖时间进行匹配。使用Kaplan-Meier图和Cox比例风险模型，对随后8-10年的总死亡率和原因特异性死亡率进行比较，并根据Charlson合并症指数（CCI）进行调整。结果：纳入6024例MG事件和30,083例对照受益人。MG组的死亡率高于对照组（66.8 vs 57.1 / 1000人/年）。讨论：老年MG患者的长期死亡率高于非MG患者，这是由于他们较高的合并症负担所致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Muscle & Nerve 医学-临床神经学

CiteScore

6.40

自引率

5.90%

发文量

287

审稿时长

3-6 weeks

期刊介绍： Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.