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Topolnitskiy E.B.

Siberian State Medical University;
Tomsk Regional Clinical Hospital;
Tomsk State University

Gusakov V.V.

Siberian State Medical University;
Tomsk Regional Clinical Hospital

Comparison of prognostic scales of myasthenic crisis after thymectomy in patients with myasthenia gravis

Authors:

Topolnitskiy E.B., Gusakov V.V.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(6): 63‑69

DOI: 10.17116/anaesthesiology202406163

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Table of contents

COMPARISON OF PROGNOSTIC SCALES OF MYASTHENIC CRISIS AFTER THYMECTOMY IN PATIENTS WITH MYASTHENIA GRAVIS
COMPARISON OF PROGNOSTIC SCALES OF MYASTHENIC CRISIS AFTER THYMECTOMY IN PATIENTS WITH MYASTHENIA GRAVIS

To cite this article:

Topolnitskiy EB, Gusakov VV. Comparison of prognostic scales of myasthenic crisis after thymectomy in patients with myasthenia gravis. Russian Journal of Anesthesiology and Reanimatology. 2024;(6):63‑69. (In Russ.)
https://doi.org/10.17116/anaesthesiology202406163

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Abstract:

Myasthenia gravis (MG) is an autoimmune disease accompanied by muscle weakness and abnormal muscle fatigue. Thymectomy (TE) is advisable for these patients. Some anesthetic prognostic scales were proposed to assess the likelihood of postoperative myasthenic crisis (POMC). There are no literature data on comparison of prognostic scales for this postoperative complication.

OBJECTIVE

To compare prognostic effectiveness of different scales in prediction of POMC after TE in MG patients.

MATERIAL AND METHODS

We retrospectively analyzed 37 case histories of seropositive MG patients who underwent TE under general anesthesia. ROC-analysis was performed to compare 5 prognostic sales.

RESULTS

The scale by T. Kanai et al. with VC% (0.93 [95% CI 47.8—100.0]) and FVC% (0.90 [95% CI 47.8—100]), as well as QMGS scale (0.94 [95% CI 89.1—100.0]) showed higher results compared to scales by S.R. Leventhal et al. (0.67 [95% CI 14.7—94.7]) and G. Leuzzi et al. (0.80 [95% CI 58.4—99.5]) in predicting POMC. Pairwise comparison with DeLong test found no significant differences.

CONCLUSION

Kanai and QMGS scales are preferable for prediction of postoperative myasthenic crisis after thymectomy in patients with myasthenia gravis.

Keywords:

myasthenia
myasthenic crisis
anesthesia
thoracoscopic thymectomy
prognostic scales
perioperative management

Authors:

Topolnitskiy E.B.

Siberian State Medical University;
Tomsk Regional Clinical Hospital;
Tomsk State University

Gusakov V.V.

Siberian State Medical University;
Tomsk Regional Clinical Hospital

Received:

16.06.2024

Accepted:

17.07.2024

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References:

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