Hospitalizations and Mortality From Myasthenia Gravis: Trends From 2 US National Datasets

Area of Science:

• Neurology
• Epidemiology
• Public Health

Background:

• Myasthenia gravis (MG) is a rare neuromuscular disorder causing significant muscle weakness due to autoimmune nerve-muscle communication damage.
• MG exacerbations, including myasthenic crisis with respiratory failure, represent serious manifestations of the disease.
• Recent data indicate a rising prevalence of MG, with a notable increase observed in older patient populations.

Purpose of the Study:

• To examine trends in hospital admissions and in-hospital mortality for adult patients diagnosed with MG.
• To assess readmissions and postdischarge mortality specifically in older adults (65 years and above) with MG.
• To analyze hospitalization patterns and outcomes related to MG exacerbations and crisis over a defined period.

Main Methods:

• Utilized the Nationwide Inpatient Sample (NIS) database to analyze trends in MG hospitalizations and in-hospital mortality for adults (≥18 years).
• Employed the Medicare Limited Data Set to evaluate hospitalizations, length of stay, readmissions, and 30-day postdischarge mortality in fee-for-service Medicare beneficiaries (≥65 years).
• Analyzed data from 2010-2019 using multinomial logit models and Poisson regression to determine the significance of observed trends.

Main Results:

• Hospitalization rates for adult MG patients increased annually by 4.9% (noncrisis 4.4%, crisis 6.8%) from 2010-2019.
• Readmission rates remained around 20% annually, with an average in-hospital mortality of 1.8%.
• Older adults (≥65 years) showed higher annualized hospitalization increases (5.2% overall, 7.7% for crisis) and significantly higher mortality rates (averaging 5.0%) compared to the general adult population.

Conclusions:

• The increasing hospitalization rates for myasthenia gravis signify a growing public health burden, especially among the elderly.
• Despite stable readmission and mortality percentages, the absolute number of MG-related readmissions and deaths is rising due to increased admissions.
• Hospitalized older adults with MG face considerably higher mortality risks, underscoring the need for targeted interventions and care strategies for this demographic.