Dataset Information

Myasthenic crisis treated in a Chinese neurological intensive care unit: clinical features, mortality, outcomes, and predictors of survival.

ABSTRACT:

Background

Myasthenic crisis (MC) often requires admission to an intensive care unit (ICU).

Methods

We retrospectively investigated 113 consecutive patients with first MC admitted to the neurological ICU. Patients' demographic, clinical and other characteristics were examined, as well as therapeutic interventions, mortality and functional outcome.

Results

MC patients at first onset admitted to neurological ICU had a mortality rate of 18.6%. PCO₂ level before intubation and score on Myasthenia Gravis-Activities of Daily Living (MG-ADL) scale at MC onset correlated with duration of ventilation and length of ICU stay. Compared with patients with good functional outcome, patients with intermediate or poor functional outcome were older at first MC onset, had lower pH and PO₂, and had higher PCO₂ before intubation. Multivariate logistic analysis identified pre-intubation PCO₂ level as an independent predictor of survival. Cox regression showed that age at first MC onset requiring ICU management was the factor which significantly influenced the mortality.

Conclusions

Our results suggest that PCO₂ before intubation and MG-ADL score at MC onset may be useful indicators of more severe disease likely to require extensive respiratory support and ICU management. Higher pre-intubation PCO₂ indicates chronic respiratory acidosis that can increase risk of severe disability and death, especially in patients with older age at first MC onset.

SUBMITTER: Liu F

PROVIDER: S-EPMC6642475 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Myasthenic crisis treated in a Chinese neurological intensive care unit: clinical features, mortality, outcomes, and predictors of survival.

Liu Fan F Wang Qiong Q Chen Xueping X

BMC neurology 20190719 1

<h4>Background</h4>Myasthenic crisis (MC) often requires admission to an intensive care unit (ICU).<h4>Methods</h4>We retrospectively investigated 113 consecutive patients with first MC admitted to the neurological ICU. Patients' demographic, clinical and other characteristics were examined, as well as therapeutic interventions, mortality and functional outcome.<h4>Results</h4>MC patients at first onset admitted to neurological ICU had a mortality rate of 18.6%. PCO<sub>2</sub> level before intu ...[more]

PMID: 31324153

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Project description:BACKGROUND:Majority burn mortality prognostic scores were developed and validated in western populations. The primary objective of this study was to evaluate and identify possible risk factors which may be used to predict burns mortality in a local Malaysian burns intensive care unit. The secondary objective was to validate the five well known burn prognostic scores (Baux score, Abbreviated Burn Severity Index (ABSI) score, Ryan score, Belgium Outcome Burn Injury (BOBI) score and revised Baux score) to predict burn mortality prediction. METHODS:Patients that were treated at the Hospital Sultan Ismail's Burns Intensive Care (BICU) unit for acute burn injuries between 1 January 2010 to 31 December 2017 were included. Risk factors to predict in-patient burn mortality were gender, age, mechanism of injury, total body surface area burn (TBSA), inhalational injury, mechanical ventilation, presence of tracheotomy, time from of burn injury to BICU admission and initial centre of first emergency treatment was administered. These variables were analysed using univariate and multivariate analysis for the outcomes of death. All patients were scored retrospectively using the five-burn mortality prognostic scores. Predictive ability for burn mortality was analysed using the area under receiver operating curve (AUROC). RESULTS:A total of 525 patients (372 males and 153 females) with mean age of 34.5?±?14.6?years were included. There were 463 survivors and 62 deaths (11.8% mortality rate). The outcome of the primary objective showed that amongst the burn mortality risk factors that remained after multivariate analysis were older age (p?=?0.004), wider TBSA burn (p?<?0.001) and presence of mechanical ventilation (p?<?0.001). Outcome of secondary objective showed good AUROC value for the prediction of burn death for all five burn prediction scores (Baux score; AUROC:0.9, ABSI score; AUROC:0.92, Ryan score; AUROC:0.87, BOBI score; AUROC:0.91 and revised Baux score; AUROC:0.94). The revised Baux score had the best AUROC value of 0.94 to predict burns mortality. CONCLUSION:Current study evaluated and identified older age, total body surface area burns, and mechanical ventilation as significant predictors of burn mortality. In addition, the revised Baux score was the most accurate burn mortality risk score to predict mortality in a Malaysian burn's population.

Dataset Information

Myasthenic crisis treated in a Chinese neurological intensive care unit: clinical features, mortality, outcomes, and predictors of survival.

Background

Methods

Results

Conclusions

Publications

Myasthenic crisis treated in a Chinese neurological intensive care unit: clinical features, mortality, outcomes, and predictors of survival.

Similar Datasets

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