2002年至2011年纽约州门诊手术中心出院记录中恶性高热诊断的患病率

Prevalence of Malignant Hyperthermia Diagnosis in New York State Ambulatory Surgery Center Discharge Records 2002 to 2011.

作者信息

Lu Zhen, Rosenberg Henry, Brady Joanne E, Li Guohua

机构信息

From the *Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York; †Department of Medical Education and Clinical Research, Saint Barnabas Medical Center, Livingston, New Jersey; and ‡Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York.

出版信息

Anesth Analg. 2016 Feb;122(2):449-53. doi: 10.1213/ANE.0000000000001054.

DOI:10.1213/ANE.0000000000001054

PMID:26554462

Abstract

BACKGROUND

Malignant hyperthermia (MH) is a rare yet potentially fatal pharmacogenetic disorder triggered by exposure to inhaled anesthetics and the depolarizing neuromuscular blocking drug succinylcholine. Epidemiologic research on MH is largely limited to inpatients. In this study, we examined the prevalence of recorded MH diagnosis in patients discharged from ambulatory surgery centers (ASCs).

METHODS

We analyzed the New York State Ambulatory Surgery Dataset for the years 2002 to 2011 and identified patients with a discharge diagnosis of MH due to anesthesia by using the International Classification of Disease, Ninth Revision, Clinical Modification code 995.86. MH prevalence was assessed by demographic, clinical, and ASC characteristics.

RESULTS

During the study period, 31 of 17,092,765 discharges from ASCs had a recorded diagnosis of MH, yielding a prevalence of 0.18 per 100,000 discharges (95% confidence interval, 0.12-0.25). The prevalence of recorded MH diagnosis per discharge differed significantly across age groups and surgical procedure categories. All patients with a recorded diagnosis of MH were from hospital-based ASCs and were discharged alive from ASCs.

CONCLUSIONS

The prevalence of recorded MH diagnosis in ASC patients is approximately 1 per 500,000 and varies considerably with surgical procedures.

摘要

背景

恶性高热（MH）是一种罕见但可能致命的药物遗传疾病，由吸入麻醉剂和去极化神经肌肉阻滞剂琥珀酰胆碱引发。关于恶性高热的流行病学研究主要局限于住院患者。在本研究中，我们调查了门诊手术中心（ASC）出院患者中记录的恶性高热诊断患病率。

方法

我们分析了2002年至2011年纽约州门诊手术数据集，并使用国际疾病分类第九版临床修订本代码995.86识别因麻醉导致出院诊断为恶性高热的患者。通过人口统计学、临床和门诊手术中心特征评估恶性高热患病率。

结果

在研究期间，门诊手术中心的17092765例出院病例中有31例记录了恶性高热诊断，患病率为每100000例出院病例中有0.18例（95%置信区间，0.12 - 0.25）。记录的每次出院恶性高热诊断患病率在不同年龄组和手术类别之间存在显著差异。所有记录有恶性高热诊断的患者均来自医院附属门诊手术中心，且从门诊手术中心出院时存活。