Department of Neurology, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China.
Department of Neurology, Huashan Hospital Fudan University, Shanghai, China.
Eur Neurol. 2019;81(5-6):287-293. doi: 10.1159/000503961. Epub 2019 Oct 29.
Myasthenic crisis (MC) is a life-threatening condition usually occurred in patients with myasthenia gravis (MG).
On the basis of a retrospective case series review, we try to develop a scoring system to evaluate the probability for in-hospital death in MC patients.
We retrospectively reviewed 78 MC patients who were hospitalized from January 2014 to December 2018. Clinical and laboratory data including 17 variables were analyzed univariately. The main clinical outcome was defined as the in-hospital death. Then eligible variables were evaluated by a stepwise multivariate regression and a scoring system was then generated. Calibration and discrimination methods were used to evaluate and validate the model performance.
The overall in-hospital mortality was 11.5% (9/78) in the MC cohort. Five clinical variables including Myasthenia Gravis Foundation of America (MGFA) classification at onset, septic shock, thymoma classification, cardiac arrest, and the lowest serum albumin were found to be associated with in-hospital mortality. Further 3 variables entered the final regression, and internal validation showed that the area under the curve was 0.919 (95% CI 0.788-1.000). A scoring system with a full credit of 7 points was generated to predict the in-hospital mortality (MGFA at onset, 2 points; septic shock, 4 points; and cardiac arrest, 3 points).
A 7-point scoring model was established on the basis of a retrospective review of MC patients to predict the in-hospital mortality.
肌无力危象（MC）是一种危及生命的疾病，通常发生在重症肌无力（MG）患者中。
基于回顾性病例系列回顾，我们试图开发一种评分系统来评估 MC 患者住院期间死亡的概率。
我们回顾性分析了 2014 年 1 月至 2018 年 12 月期间住院的 78 例 MC 患者。对包括 17 个变量在内的临床和实验室数据进行单因素分析。主要临床结局定义为住院期间死亡。然后对有资格的变量进行逐步多变量回归分析，并生成评分系统。采用校准和判别方法评估和验证模型性能。
在 MC 队列中，总体住院死亡率为 11.5%（9/78）。五项临床变量，包括发病时的美国重症肌无力基金会（MGFA）分类、感染性休克、胸腺瘤分类、心脏骤停和最低血清白蛋白，与住院死亡率相关。进一步有 3 个变量进入最终回归，内部验证显示曲线下面积为 0.919（95%CI 0.788-1.000）。生成了一个满分为 7 分的评分系统，用于预测住院死亡率（发病时的 MGFA，2 分；感染性休克，4 分；心脏骤停，3 分）。
基于 MC 患者的回顾性分析，建立了一个 7 分评分模型来预测住院死亡率。
