Hospital admission and prevalence trends of adult myasthenia gravis in Finland in 2004–2014: A retrospective national registry study

  • Jussi O.T. Sipilä
    Correspondence
    Corresponding author at: Department of Neurology, Siun sote, North Karelia Central Hospital, Tikkamäentie 16, FI-80210 Joensuu, Finland.
    Affiliations
    Department of Neurology, Siun sote, North Karelia Central Hospital, Joensuu, Finland, Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland, Department of Neurology, University of Turku, Turku, Finland
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  • Merja Soilu-Hänninen
    Affiliations
    Turku University Hospital, Division of Clinical Neurosciences, Turku, Finland, Department of Neurology, University of Turku, Turku, Finland
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  • Päivi Rautava
    Affiliations
    Department of Public Health, University of Turku and Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
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  • Ville Kytö
    Affiliations
    Heart Center, Turku University Hospital, Turku, Finland, Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Center for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
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Published:October 17, 2019DOI:https://doi.org/10.1016/j.jns.2019.116520

      Highlights

      • Annual MG hospitalisation frequency remained stable.
      • Medication approval data suggested increasing MG prevalence.
      • The proportion of infection-associated admissions increased.
      • In-hospital mortality was predicted by age and infection.
      • The annual frequencies of plasmaphereses or thymectomies showed no change.

      Abstract

      Hospital admission trends in Myasthenia Gravis are largely unknown, so they were here investigated in Finland between 2004 and 2014 using national mandatory registry data. There were 2989 hospital admissions (59.7% for women) for 861 individuals (median 2 admissions/individual) The annual number of admissions (p = .56), the age of admitted patients (p = .24) or length of stay (p = .20) showed no change during the study period. The proportion of infections as the primary diagnosis increased from 4.5% to 10.4% (p = .0056). These admissions lasted longer than admissions with a non-infectious primary diagnosis (median 6 vs. 4 days, p < .0001). In-hospital mortality rate was 1.0%, predicted by age over 65 (HR 8.8; p = .0034) and infection as the primary diagnosis (HR 6.9; p < .0001). Annual frequencies of thymectomies (p = .66) or plasmaphereses (p = .12) remained unchanged. Myasthenia drug reimbursement data suggested increasing MG prevalence during the study period (p < .00001). Considering that the annual hospitalisation frequency remained stable, this would suggest decreased need of hospitalisations per patient. The importance of infections as causes of myasthenia hospitalisations merits further study.

      Keywords

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