1997 Volume 11 Issue 2 Pages 136-143
On the pre- and post- operative clinical manegement of thymectomized patients, immunosuppressive therapy by alternate-day administration of prednisolone (PSL) before thymectomy seems to got higher safety than the usual preoperative administration of aniti-cholineesterase (anti-ChE). But, postoperative respiratory care is still important problem.
100 postoperative patients with generalized myasthenia gravis combined alternate-day administration of PSL from January 1979 to March 1996 were analysed retrospectively. As a result, prediction model of postoperative respiratory failure was proposed by logistic regres-sion.
The three factors-reoperative medication (p <0.0001), %FVC (p=0.0001), preoperative clinical severity (p<0.0001) -was most important in postoperative respiratory failure. The prediction model was calculated from the five factors which added two factors-sex and history of crisis-. This model achieved a sensitivity of 80.0%, a specificity of 97.7% and an accuracy of 96.0%.
This logistic model may be clinically useful for the prediction of postoperative respiratory care after thymectomy combined PSL alternative-day in MG.
