Table 2.
Comparison of matched MuSK- and AChR-AB positive myasthenic crisis requiring reintubation
| Myasthenic crisis | ACh-Rec.-positive (n = 57) | MuSK—positive (n = 19) | p value | Odds ratio |
|---|---|---|---|---|
| Age | 66.3 ± 17.0 (24–88) | 66.0 ± 17.7 (28–82) | 0.95 | |
| Male/female | 22/35 | 7/12 | 1.00 | 1.08 |
| ≥ 3 diseases (Kidney, Heart, Lung, Diabetes, Tumour) | 14 (24.6%) | 5 (26.3%) | 1.00 | 1.10 |
| Late-onset Myasthenia gravis | 44 (77.2%) | 14 (77.8%; 1 unknown) | 1.00 | 1.03 |
| MGFA-classification before crisis | ||||
| First manifestation of MG | 9 (15.8%) | 3 (15.8%) | 1.00 | 1.00 |
| Class I | 0 (0%) | 0 (0%) | ||
| Class II | 14 (24.6%) | 4 (21.1%) | 1.00 | 0.82 |
| Class III | 16 (28.1%) | 5 (26.3%) | 1.00 | 0.92 |
| Class IV | 16 (28.1%) | 6 (31.6%) | 0.78 | 1.18 |
| Unknown | 2 (3.5%) | 1 (5.3%) | 1.00 | 1.54 |
| Status before crisis | ||||
| Independent at home | 25 (43.9%) | 6 (31.6%) | 0.42 | 0.59 |
| At home dependent on help | 5 (8.8%) | 3 (15.8%) | 0.40 | 1.96 |
| In a care facility or hospital | 16 (28.1%) | 9 (47.4%) | 0.16 | 2.31 |
| Unknown | 11 (19.3%) | 1 (5.3%) | 0.27 | 0.23 |
| Therapy | ||||
| IVIG | 36 (63.2%) | 9 (47.4%) | 0.28 | 0.53 |
| Plasma exchange/Immunoadsorption | 24 (42.1%) | 13 (68.4%) | 0.06 | 2.98 |
| PE or IA as first-line therapy | 18 (31.6%) | 10 (52.6%) | 0.11 | 2.38 |
| IVIG + plasma exchange or Immunoadsorption | 9 (15.8%) | 5 (26.3%) | 0.32 | 1.89 |
| Continuous pyridostigmine infusion | 24 (42.1%) | 7 (36.8%) | 0.79 | 0.80 |
| Continuous potassium infusion | 23 (40.4%) | 6 (31.6%) | 0.59 | 0.68 |
| Complications | ||||
| CPR | 9 (15.8%) | 2 (10.5%) | 0.72 | 0.63 |
| Pneumonia | 34 (59.7%) | 13 (68.4%) | 0.59 | 1.47 |
| Sepsis | 14 (24.6%) | 6 (31.6%) | 0.56 | 1.41 |
| Outcome | ||||
| Days of mechanical ventilation at ICU | 18.8 ± 21.9 (1–119) | 43.0 ± 53.1 (4–219) | 0.0078 | |
| Days at ICU | 22.3 ± 21.0 (1–119) | 45.3 ± 49.5 (6–219) | 0.0067 | |
| Days in hospital | 26.9 ± 20.6 (2–119) | 55.9 ± 47.6 (11–219) | 0.0006 | |
| In-hospital mortality | 5 (8.8%) | 3 (15.8%) | 0.40 | 1.95 |
Age is depicted as mean ± Standard Deviation and range, other parameters are total number with percentage in brackets. MGFA Myasthenia Gravis Foundation of America, MG Myasthenia Gravis, IVIG intravenous immunoglobulin, PE plasma exchange, IA immunoadsorption, CPR Cardio Pulmonal Resuscitation. T test was used for statistic analysis of age-differences. For other parameters, Fisher’s exact test with odds ratio was used
Significant result (p ≤ 0.05) are shown in bold letters