title: Trends in Outcomes and Hospitalization Charges among Mechanically Ventilated Patients with Myasthenia Gravis in the United States.
abstract: BACKGROUND
  To assess the impact of new therapeutic strategies on outcome and cost of hospitalization among patients with myasthenia gravis (MG) who are mechanically ventilated in United States.
  
  
  METHODS
  Using a retrospective analysis of cross sectional survey, we determined the rates of occurrence, in-hospital outcomes, and mean hospital charges for patients hospitalized with MG requiring mechanical ventilation in 1991-1992 using the Nationwide Inpatient Survey (NIS) and compared these outcomes with homologous data from 2001-2002. NIS is the largest all-payer inpatient care database in the United States.
  
  
  RESULTS
  When comparing data from 2001-2002 with data from 1991-1992, we found a higher number of admissions for MG that required mechanical ventilation (994 vs. 652). The proportion of women was similar (53% vs. 60%). The average age (in years ± standard deviation) was significantly higher (65 ± 17 vs. 58 ± 18, p=0.0002). The length of hospitalization (in days ± standard deviation) was not different (22 ± 19 vs. 21 ± 16). Discharge to home occurred less frequently (29% vs. 60%, p=0.0001) and in hospital mortality minimally lower (13% vs. 15%). There was a significant increase in mean hospital charges ($118,000 vs. $84,100 adjusted for inflation, p=0.0001). In hospital mortality was higher among urban teaching hospitals compared with urban non teaching hospitals in 2001-2002.
  
  
  CONCLUSIONS
  Despite improvement in therapeutic strategies from 1991 to 2002, there was only a modest reduction in mortality and no substantial reduction of length of hospitalization for patients with MG requiring mechanical ventilation.
authors.affiliation: Department of Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA; Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Nizar
authors.initials: N
authors.lastname: Souayah
authors.forename: Abu
authors.initials: A
authors.lastname: Nasar
authors.forename: M Fareed K
authors.initials: MF
authors.lastname: Suri
authors.forename: Jawad F
authors.initials: JF
authors.lastname: Kirmani
authors.forename: Mustapha A
authors.initials: MA
authors.lastname: Ezzeddine
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
keywords: cost; length of stay; mechanical ventilation; mortality; myasthenia crisis; myasthenia gravis; outcome