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Table 2 Significant risk factors associated with MCAT and the results of bias risk assessment

From: Assessment of the risks of a myasthenic crisis after thymectomy in patients with myasthenia gravis: a systematic review and meta-analysis of 25 studies

Significant Risk Factors

 

No. of studies

No. of MC

No. of total patients

Analysis model

Adjusted OR (95%CI)

Study heterogeneity

Test for overall effect

Begg’s test P value

       

Q

P

I2,%

Z

P value

 

Preoperative patient condition-related risk factors

 Preoperative MC history

 

12

377

2094

Fixed

4.13 [3.08, 5.54]

13.46

0.26

18

9.46

<0.00001

0.034

without

ref

          

with

           

 Preoperative bulbar symptoms

 

8

254

1443

Fixed

3.71 [2.54, 5.42]

7.55

0.37

7

6.76

<0.00001

0.174

without

ref

          

with

           

 Preoperative Osserman stages

 

10

358

2040

Fixed

4.55 [3.23, 6.13]

30.74

0.0006

67

9.15

<0.00001

0.64

I

ref

          

IIa + IIb + III + VI

2

   

2.57 [1.43,4.61]

0.01

0.94

0

3.16

0.002

 

IIb + III + VI

8

   

11.15 [6.88,18.08]

5.41

0.61

0

9.78

<0.00001

 

VI + V

1

   

1.80 [0.96, 3.36]

NA

NA

NA

1.84

0.002

 

 Postoperative lung infection

 

5

92

448

Fixed

6.49 [2.64, 15.98]

2.39

0.5

0

4.07

<0.00001

0.624

without

ref

          

with

           

 Thymoma

 

5

234

1390

Fixed

2.96 [2.13, 4.13]

3.63

0.3

17

6.43

<0.00001

0.806

no

ref

          

yes

           

 Preoperative dosage of pyridostigmine bromide

 

4

193

1103

Fixed

3.53 [2.47,5.03]

4.98

0.17

40

6.94

<0.00001

1

≥240 mg

           

<240 mg

ref

          

 Preoperative serum AchR-Ab level (nm/L)

 

2

27

248

Fixed

8.74 [3.31, 23.08]

0.03

0.87

0

3.65

0.0003

1

>100

           

≤100

ref

          

 Operation time

 

3

95

325

Random

1.18 [0.89, 1.57]

19.47

<0.00001

90

1.13

0.26

0.296

Surgery-related risk factors

 Intraoperative blood loss > 1000 ml

 

2

26

185

Fixed

15.03 [3.50, 64.50]

0.03

0.87

0

3.65

0.0003

1

>1000 ml

           

≤1000 ml

ref

          

 WHO classification

 

2

25

190

Fixed

15.23 [4.63, 50.13]

0.22

0.64

0

4.48

<0.00001

1

non-thymoma and non-invasive thymoma

ref

          

invasive thymoma

           

 Mode of operation

 

4

66

252

Fixed

5.88 [2.06,16.80]

2.09

0.55

0

3.3

0.001

0.089

video-assisted thoracoscopy

ref

          

thoracotomy

           

Postoperative risk factors

 Preoperative lung function

 

5

110

784

Fixed

5.71 [3.11, 10.48]

3.3

0.51

0

5.62

<0.00001

1

normal

ref

          

abnormal

           

 Major postoperative complications

 

3

87

391

Fixed

33.78 [10.57,107.96]

1.59

0.45

0

5.94

<0.00001

1

without

ref

          

with

           

 Disease duration before thymectomy

 

2

39

452

Fixed

5.45 [1.96, 15.14]

0.02

0.9

0

3.26

0.001

1

  

1983

11,345

        
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Journal of Cardiothoracic Surgery

ISSN: 1749-8090

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