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Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study

OBJECTIVE: To validate the comprehensive features of adverse outcomes after surgery for patients with myasthenia gravis. METHODS: Using reimbursement claims from Taiwan’s National Health Insurance Research Database, we analyzed 2290 patients who received major surgery between 2004 and 2010 and were...

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Autores principales: Chang, Yi-Wen, Chou, Yi-Chun, Yeh, Chun-Chieh, Hu, Chaur-Jong, Hung, Chih-Jen, Lin, Chao-Shun, Chen, Ta-Liang, Liao, Chien-Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493398/
https://www.ncbi.nlm.nih.gov/pubmed/28666024
http://dx.doi.org/10.1371/journal.pone.0180433
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author Chang, Yi-Wen
Chou, Yi-Chun
Yeh, Chun-Chieh
Hu, Chaur-Jong
Hung, Chih-Jen
Lin, Chao-Shun
Chen, Ta-Liang
Liao, Chien-Chang
author_facet Chang, Yi-Wen
Chou, Yi-Chun
Yeh, Chun-Chieh
Hu, Chaur-Jong
Hung, Chih-Jen
Lin, Chao-Shun
Chen, Ta-Liang
Liao, Chien-Chang
author_sort Chang, Yi-Wen
collection PubMed
description OBJECTIVE: To validate the comprehensive features of adverse outcomes after surgery for patients with myasthenia gravis. METHODS: Using reimbursement claims from Taiwan’s National Health Insurance Research Database, we analyzed 2290 patients who received major surgery between 2004 and 2010 and were diagnosed with myasthenia gravis preoperatively. Surgical patients without myasthenia gravis (n = 22,900) were randomly selected by matching procedure with propensity score for comparison. The adjusted odds ratios and 95% confidence intervals of postoperative adverse events associated with preoperative myasthenia gravis were calculated under the multiple logistic regressions. RESULTS: Compared with surgical patients without myasthenia gravis, surgical patients with myasthenia gravis had higher risks of postoperative pneumonia (OR = 2.09; 95% CI: 1.65–2.65), septicemia (OR = 1.31; 95% CI: 1.05–1.64), postoperative bleeding (OR = 1.71; 95% CI: 1.07–2.72), and overall complications (OR = 1.70; 95% CI: 1.44–2.00). The ORs of postoperative adverse events for patients with myasthenia gravis who had symptomatic therapy, chronic immunotherapy, and short-term immunotherapy were 1.76 (95% CI 1.50–2.08), 1.70 (95% CI 1.36–2.11), and 4.36 (95% CI 2.11–9.04), respectively. CONCLUSIONS: Patients with myasthenia gravis had increased risks of postoperative adverse events, particularly those experiencing emergency care, hospitalization, and thymectomy for care of myasthenia gravis. Our findings suggest the urgency of revising protocols for perioperative care for these populations.
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spelling pubmed-54933982017-07-18 Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study Chang, Yi-Wen Chou, Yi-Chun Yeh, Chun-Chieh Hu, Chaur-Jong Hung, Chih-Jen Lin, Chao-Shun Chen, Ta-Liang Liao, Chien-Chang PLoS One Research Article OBJECTIVE: To validate the comprehensive features of adverse outcomes after surgery for patients with myasthenia gravis. METHODS: Using reimbursement claims from Taiwan’s National Health Insurance Research Database, we analyzed 2290 patients who received major surgery between 2004 and 2010 and were diagnosed with myasthenia gravis preoperatively. Surgical patients without myasthenia gravis (n = 22,900) were randomly selected by matching procedure with propensity score for comparison. The adjusted odds ratios and 95% confidence intervals of postoperative adverse events associated with preoperative myasthenia gravis were calculated under the multiple logistic regressions. RESULTS: Compared with surgical patients without myasthenia gravis, surgical patients with myasthenia gravis had higher risks of postoperative pneumonia (OR = 2.09; 95% CI: 1.65–2.65), septicemia (OR = 1.31; 95% CI: 1.05–1.64), postoperative bleeding (OR = 1.71; 95% CI: 1.07–2.72), and overall complications (OR = 1.70; 95% CI: 1.44–2.00). The ORs of postoperative adverse events for patients with myasthenia gravis who had symptomatic therapy, chronic immunotherapy, and short-term immunotherapy were 1.76 (95% CI 1.50–2.08), 1.70 (95% CI 1.36–2.11), and 4.36 (95% CI 2.11–9.04), respectively. CONCLUSIONS: Patients with myasthenia gravis had increased risks of postoperative adverse events, particularly those experiencing emergency care, hospitalization, and thymectomy for care of myasthenia gravis. Our findings suggest the urgency of revising protocols for perioperative care for these populations. Public Library of Science 2017-06-30 /pmc/articles/PMC5493398/ /pubmed/28666024 http://dx.doi.org/10.1371/journal.pone.0180433 Text en © 2017 Chang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chang, Yi-Wen
Chou, Yi-Chun
Yeh, Chun-Chieh
Hu, Chaur-Jong
Hung, Chih-Jen
Lin, Chao-Shun
Chen, Ta-Liang
Liao, Chien-Chang
Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study
title Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study
title_full Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study
title_fullStr Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study
title_full_unstemmed Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study
title_short Outcomes after major surgery in patients with myasthenia gravis: A nationwide matched cohort study
title_sort outcomes after major surgery in patients with myasthenia gravis: a nationwide matched cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493398/
https://www.ncbi.nlm.nih.gov/pubmed/28666024
http://dx.doi.org/10.1371/journal.pone.0180433
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