1-Year Clinical Outcome Post-Myasthenic Crisis: A Multicenter Prospective Study in China

Area of Science:

• Neurology
• Clinical Research
• Patient Outcomes

Background:

• Myasthenic crisis (MC) impacts 10-20% of myasthenia gravis (MG) patients, posing life-threatening risks and substantial economic burdens.
• Long-term outcomes following MC are not well understood, necessitating further investigation.

Purpose of the Study:

• To prospectively evaluate 1-year clinical outcomes in patients following a myasthenic crisis.
• To identify predictors of poor outcomes and common chronic complications post-MC.

Main Methods:

• Prospective, multicentre study enrolling 277 patients with 282 MC episodes between December 2018 and October 2024.
• Follow-up at 1, 2, 3, 6, and 12 months post-MC, assessing Myasthenia Gravis Foundation of America (MGFA) postintervention status (PIS), mortality, and complications.
• Utilized MG-ADL scores for symptom assessment and multivariable analysis for predictor identification.

Main Results:

• In-hospital mortality was 5.05%, with all-cause mortality at 15.16%. Leading causes of death were septic shock and multiple organ failure.
• Among 247 patients with 1-year follow-up, 79.76% achieved favorable outcomes, with significant reduction in MG-ADL scores (p < 0.01).
• Older age, thymoma, higher comorbidity burden, and prolonged ICU stay predicted poor response. Frequent chronic complications included infections, gastrointestinal disorders, and osteoporosis.

Conclusions:

• This is the first prospective cohort study detailing clinical outcomes post-myasthenic crisis.
• Findings underscore the importance of vigilant disease monitoring and timely intervention to enhance patient-centered care for myasthenia gravis survivors.