Medical Student Research Fellowship for Summer 2012
Mentor: Eric Rosero, M.D.
Department: Department of Anesthesiology
Room number: CS2.106
Mail Code: 9068
Phone number: 214-648-3657
Project title: Nationwide in-hospital postoperative outcomes of patients with myasthenia gravis undergoing abdominal surgery
Human subjects IRB approved project number (where applicable): NA
Animal subjects IRB approved project number (where applicable): NA
Project Type: patient-based (national database)
Brief Description of Project:
Myasthenia gravis is a neuromuscular autoimmune disorder characterized by antibodies against acetylcholine receptors at the neuromuscular junction. Patients have fluctuating weakness and fatigability, which increases their risk of adverse postoperative outcomes. Patients with myasthenia gravis are given special consideration when undergoing abdominal surgery. They are at higher risk for postoperative respiratory problems related to altered respiratory mechanics caused by pain, inflammation, general anesthetic agents, mechanical ventilation, and physical stress. However, national in-hospital outcomes of patients with myasthenia gravis undergoing abdominal surgery have not been studied.
The purpose of this study is to assess nationwide incidence of in-hospital mortality, myocardial infarction, stroke, acute renal failure, pulmonary embolism, pneumonia, post-operative mechanical ventilation, and tracheostomies in myasthenic patients compared to non-myasthenic patients undergoing abdominal surgery in the United States. In addition, length of stay and charges accrued will be evaluated between the groups.
Data from the National Inpatient Sample (NIS) from 2005 to 2009 will be used to identify patients with and without a diagnosis of myasthenia gravis undergoing abdominal surgery. Baseline demographic characteristics (age, gender, and race) and hospital characteristics (teaching status, urban vs. rural location, bed size, and geographic location) will be described for each group. The Charlson comorbidity index will be calculated as a measure of comorbidity burden for each patient. Logistic regression models will be conducted based on these previously described characteristics to calculate propensity scores for each patient. These scores will be used to find a matched cohort of patients with and without myasthenia gravis who share similar characteristics. Postoperative outcomes between the two groups will be compared using appropriate statistical methods.
Role of student: The medical student will help with project design, literature review, statistical analysis, and writing the manuscript. The student will help create the database subset and help analyze the data using statistical analytics software (such as SAS).
Previous Research Activities or Publications with Medical Students: