Analysis of influencing factors of perioperative myasthenic crisis in 387 myasthenia gravis patients without thymoma in a single center

J Cardiothorac Surg. 2023 Jan 12;18(1):20. doi: 10.1186/s13019-023-02136-1.

Abstract

Objective: To study the influencing factors of myasthenic crisis in non-thymoma myasthenia gravis (MG) patients during perioperative period.

Methods: We retrospectively analyzed a total of 387 non-thymoma MG patients who underwent extended thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from February 2011 to December 2021, recorded ASA score, Osserman classification, preoperative course, pyridostigmine dosage, operation method, operation time, and intraoperative blood loss, then analyzed the factors associated with postoperative myasthenic crisis by univariate and multivariate logistic regression.

Results: Osserman classification IIB + III + IV (P < 0.001), history of myasthenic crisis (P = 0.013), pyridostigmine dosage greater than 240 (P < 0.001), ASA score 2 and 3 (P = 0.001) are independent risk factors for myasthenic crisis.

Conclusion: Patients with poor Osserman classification, history of myasthenic crisis before surgery, larger preoperative dosage of pyridostigmine, and higher ASA scores should be highly alert to the occurrence of postoperative myasthenic crisis.

Keywords: ASA score; Myasthenia gravis; Postoperative Myasthenic crisis; Thymectomy.

MeSH terms

  • Humans
  • Myasthenia Gravis* / complications
  • Myasthenia Gravis* / surgery
  • Postoperative Complications / etiology
  • Pyridostigmine Bromide / therapeutic use
  • Retrospective Studies
  • Thymectomy / adverse effects
  • Thymectomy / methods
  • Thymoma* / complications
  • Thymoma* / surgery
  • Thymus Neoplasms* / complications
  • Thymus Neoplasms* / surgery

Substances

  • Pyridostigmine Bromide