Thymectomy is safe for myasthenia gravis patients: Analysis of the NSQIP database.
BACKGROUND
The aim of this study was to determine thymectomy-associated morbidity and mortality outcomes among myasthenia gravis (MG) patients.


METHODS
Patients undergoing thymectomy were identified from the National Surgical Quality Improvement Program database from 2005 to 2012 using Current Procedural Terminology codes. Patient demographics, clinical characteristics, and postoperative outcomes were stratified by MG diagnosis. Logistic regression was used to identify predictors for morbidity outcomes. The chi-square test was used to examine the association between MG diagnosis and surgical approach.


RESULTS
A total of 1,148 subjects underwent thymectomy, and 108 had MG. Compared with control subjects, MG patients had a more severe American Society of Anesthesiologists physical classification and frailty index score, greater corticosteroid usage, and a higher rate of reintubation. There were no deaths among MG patients. The majority of MG patients underwent transsternal thymectomy.


CONCLUSIONS
Although patients with MG have a greater preoperative morbidity and a higher frequency of reintubation, thymectomy was found to be a safe procedure overall.
Department of Neurology, The George Washington University, 2150 Pennsylvania Avenue NW, 9th Floor, Washington, DC, 20037, USA.
Jumana T
JT
Alshaikh
Department of Surgery, The George Washington University, Washington, DC, USA.
Richard
R
Amdur
Department of Surgery, The George Washington University, Washington, DC, USA.
Anton
A
Sidawy
Department of Surgery, The George Washington University, Washington, DC, USA.|Division of Cardiothoracic Surgery, The George Washington University, Washington, DC, USA.
Gregory
G
Trachiotis
Department of Neurology, The George Washington University, 2150 Pennsylvania Avenue NW, 9th Floor, Washington, DC, 20037, USA.
Henry J
HJ
Kaminski
D000328:Adult; D000368:Aged; D000574:American Medical Association; D016009:Chi-Square Distribution; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009157:Myasthenia Gravis / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality*; D012189:Retrospective Studies; D012955:Societies, Medical / Q000706:statistics & numerical data; D013934:Thymectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States
NSQIP; complications; myasthenia gravis; neuromuscular; outcome; thoracoscopic thymectomy; thymectomy