JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. X, n 2, December 2023

Pages: 1247-1254
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Predictive Factors of Post- Operative Myasthenic Crisis after Thymectomy In Moroccan Patients with Myasthenia Gravis:

A Retrospective Analysis of 30 Cases.

Author: Fatima Zahra Haddari, Soumaya Touzani, Abderrahim El Bouazzaoui, Nawfal Houari, Brahim Boukatta, Nabil Kanjaa

Category: JMSR Anesthesiology and IC

Abstract:

Introduction: Myasthenia crisis (MC) occurs in 15 % to 20 % of myasthenia gravis (MG) patients. How to prevent post-operative myasthenic crisis (POMC) is of great importance to the treatment of post-surgery MG patients. Methods: Retrospective study including myasthenia patients who underwent thymectomy and were admitted to our unit from January 2013 to December 2019. Variables analyzed were age, gender, history of MC, duration of disease, diagnostic parameters, preoperative functional muscle and Leventhal scores, Ossermann classification, patient comorbidities, treatment, and outcomes. Results: Thirty patients were included in this study. The mean age was 36.86 years. The sex ratio M/F was 0.30. Twenty percent of the patients had a history of MC. Bulbar symptoms were present in 50 % of cases. Anti-acetylcholine receptor antibodies were positive in 93 % of cases. The functional muscle score varied between 60 and 100 points with a mean of 83.63 points. The mean vital capacity was 3.302 liters. The Leventhal score was greater than 10 in five patients. Curarization was necessary in 25 patients and monitored in four cases. Surgical approach was median sternotomy in 86.67 % of cases and mean surgery duration was 159.83 minutes. The univariate analysis identified 5 variables significantly (p < 0.05) associated with the occurrence of POMC: Leventhal score > 10, weak functional muscle score, low vital capacity, prolonged duration of surgery, and prolonged length of ICU stay. Conclusion : Leventhal score > 10, weak functional muscle score, low vital capacity and prolonged surgery duration were independent risk factors for POMC.

Keywords: Morocco, Myasthenia Crisis, Myasthenia Gravis, Risk Factors, Thymectomy

DOI: 10.46327/msrjg.1.000000000000250

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