Evolving Patterns of Myasthenia Gravis and Other Myoneural Disorders Related Mortality from 1999-2020: An Analysis of CDC Wonder Database
Fatima Shahid1, Ahmed Raza2, Mohammad Ammar Ur Rahman1, Luqman Munir1
1King Edward Medical University, 2Services Institute of Medical Sciences
Objective:

To investigate mortality trends associated with MG and related myoneural disorders in the US from 1999-2020. To utilize age-adjusted mortality rates (AAMR) to identify vulnerable strata, geographic hotspots, and discrepancies among epidemiological groups.


Background:
Myasthenia Gravis (MG) and other myoneural disorders are neuromuscular conditions that impair communication between nerves and muscles, leading to muscle weakness and fatigue. These disorders, often associated with autoimmune dysfunction, can result in significant morbidity and mortality.
Design/Methods:

We assessed MG and myoneural disorders mortality data obtained from CDC WONDER (Centers for Disease Control and Prevention’s Wide Ranging Online Data for Epidemiological Research) Database from 1999-2020. AAMR per 1,000,000 individuals was calculated, and annual percent changes (APC) with 95% Confidence Intervals (CIs) were calculated using Joinpoint regression analysis. The test for parallelism was deemed significant for  p<0.05, indicating non-parallel trends. Sociodemographic data, including age, sex, race, place of death, urban/rural, state, and consensus region were collected for comprehensive analysis.


Results:

40,201 mortalities due to MG and related myoneural disorders were reported between 1999-2020. A gradual upward trend in AAMR was observed from 1999 to 2014 (APC: 0.68, 95% CI: 0.20-1.15) followed by a sharp increase from 2014 to 2020 (APC: 2.84, 95% CI: 2.84-6.03). Males, 85+ age group, and Whites, exhibited higher mortality rates. The geographical hotspots for mortality were nonmetropolitan areas, California, and Midwest census region. Tests for parallelism revealed disparate trends across large central metro vs nonmetro areas (p=0.01). The highest percentage of deaths i.e. 46.30%, were reported in inpatient medical facilities.


Conclusions:

Our study revealed an upward trend in mortality rates due to MG and related myoneural disorders in the United States from 1999 to 2020 with a concerning uptick post 2014. Notable demographic and geographical disparities were observed across gender, race, and regions, underscoring the need for further research to tailor strategies for prevention and intervention.


10.1212/WNL.0000000000210813
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