Retrospective study reveals systemic inflammatory markers do not predict post-thymectomy myasthenic crisis in myasthenia gravis, highlighting the importance of preoperative bulbar symptoms.
Key Points
To compare the predictive utility of preoperative systemic inflammatory biomarkers against established clinical parameters for identifying the risk of post-thymectomy myasthenic crisis.
Retrospective analysis of a curated cohort of 49 myasthenia gravis patients who underwent thymectomy between 2012 and 2021, excluding patients with acute infections or systemic immunomodulation.
Primary outcome was post-thymectomy myasthenic crisis (requiring mechanical ventilation within 30 days post-surgery), evaluated via univariate and multivariate logistic regression and Kaplan–Meier overall survival analysis.
Post-thymectomy myasthenic crisis occurred in 32.7% (16/49) of patients, with univariate analysis identifying bulbar symptoms (OR = 9.00, P < 0.001) and AChR-Ab positivity (OR = 3.85, P = 0.03) as significant predictors.
Bulbar symptoms remained an independent predictor in multivariate modeling (OR = 12.45, P = 0.06), while all five systemic inflammatory markers (NLR, PLR, LMR, SII, SIRI) showed no significant association (all P > 0.1).
Ten-year overall survival did not differ significantly between patients with and without crisis (83% vs. 90%, P = 0.25).