Abstract Details

Title Trends and Disparities in the Utilization of Invasive and Non-invasive Mechanical Ventilation During Acute Myasthenia Gravis Exacerbation Hospitalization and Associated Outcomes: From National Inpatient Sample (NIS) 2004-2021

Topic Neuro Trauma and Critical Care

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 7-007

Objective

To identify trends in use of types of Mechanical ventilations (MV) during MG exacerbation and disparities in utilization of MV and outcomes associated with subtype

Background changing in trends and recommendations for management of respiratory failure in patients with MG exacerbation over last 2 decades. This study analyzes data from NIS (2004 to 2021)

Design/Methods MG hospitalizations (n=31,319) were identified from NIS, using ICD-9/10 and ICD-10PCS codes and utilizing MV (n=6,039) we calculated annual percent change trends,using joint point regression analysis use of invasive mechanical ventilation (IMV) and non-invasive ventilation (NIMV). Logistic regression to calculate associations between MV type, race, gender, and hospital teaching status. (LOS) and in-hospital mortality were compared across types of MV and we applied multivariate LR for associations with age, race, gender,and Charlson Comorbidity Index.

Results

(IMV) utilization has intially increased from 2004-2008 (20.57%, 95% CI: 18.29-22.85),then declined to 16.85% (95% CI: 15.24-18.46) 2008-2019,and then increase in 2020 (21.45%, 95% CI: 19.52-23.38) during covid pandemic,(NIMV) steadily increased from 3.87% in 2004 to 12.63% in 2021.Black patients (OR: 1.118, p=0.006) and Asian (OR: 1.842, p<0.001) had higher odds of requiring IMV. Females had lower odds of both requiring IMV (OR: 0.770, p<0.001) and NIMV (OR: 0.843, p<0.001).Receiving both IMV and NIMV, increased age was associated with longer LOS (p<0.001) and higher mortality (p<0.001), while Black race was associated with lower mortality (p=0.016),utilization of IMV+NIMV is high at teaching hospital (OR: 1.286, p=0.001).

Conclusions These results indicate declining trends in use of IMV and increasing trends of NIMV use or combined NIMV+IMV use during MG exacerbation hospitalization .Disparities in use of IMV, especially high proportional use of IMV in non-teaching hospitals and rural hospitals compared to combined NIMV and IMV approach at major teaching hospitals and differences outcomes for patients. Further research is needed to optimize care and address these inequities.

Authors/Disclosures
Muhammad Sohaib, MBBS PRESENTER	Mr. Sohaib has nothing to disclose.
Muhammad Tayyab Muzaffar Chaychi, MD	Muhammad Tayyab Muzaffar Chaychi, MD has nothing to disclose.
Hafiz M. Maaz (Quaid-e-Azam Medical College, Bahawalpur Pakistan)	Mr. Maaz has nothing to disclose.
Muhammad Ahmed, MD (Medical College of Georgia, Augusta University)	Dr. Ahmed has nothing to disclose.

��ɫ��

��ɫ��