Clinical Features of Suspected Malignant Hyperthermia in China from 2015 to 2020: A Retrospective Study from China Malignant Hyperthermia Emergency Assistance Group

Abstract

Purpose

Malignant hyperthermia (MH) is a rare but fatal pharmacogenetic disorder, triggered by inhalational anesthetics or succinylcholine. Since the first nonprofit academic organization China Malignant Hyperthermia Emergency Assistance WeChat-based Group (CMHEA Group) was established in 2015, they have actively participated in the diagnosis and treatment of MH patients. Based on the CMHEA Group, the aim of the study was to retrospectively analyze the characteristics of suspected MH in China from 2015 to 2020.

Methods

We conducted a retrospective analysis of the suspected MH patients from 2015 to 2020, for analyzing the current clinical diagnosis, treatment and prognosis of MH in China.

Results

A total of 58 suspected MH cases occurred from 2015 to 2020, of these, 36 cases were collected with detailed data. The MH clinical grading score of 36 patients ranged from 33 to 73, with a median of 55. Abnormal hyperthermia and hypercarbia were the most common early signs of MH. Four patients were confirmed carrying six different potential MH-causative mutations. Of the total 58 cases, 14 patients (24.1%) received dantrolene and the whole mortality rate was 53.4%. Compared to the patients not receiving dantrolene treatment, the survival rate of patients receiving dantrolene treatment was significantly higher than that of patients not receiving dantrolene (78.6% vs 36.4%, p = 0.007).

Conclusion

The current main diagnostic methods of suspected MH in China are still clinical diagnosis. Hence, it is critical to keep dantrolene for immediate accessibility with the introduction of domestic dantrolene to China. The WeChat group model has played an important but limited role in quick diagnosis and treatment of MH.

Keywords:

• malignant hyperthermia
• dantrolene
• mortality
• China

Data Sharing Statement

The datasets generated and/or analyzed during the current study are not publicly available due to individual privacy of the patients included but are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

This study was approved by the Ethics Committee of West China Hospital, Sichuan University (protocol number 2021-1387). Due to the retrospective nature of the study, which did not involve patient privacy, did not harm patients’ health and did not pose any risk to anesthesiologists participating in the survey, the board waived the need for patient written consent. The study was conducted in compliance with the Declaration of Helsinki principles, and all personal information would be kept confidential.

Consent for Publication

All the authors included signed the consent for publication.

Acknowledgments

We would like to acknowledge the membership of China Malignant Hyperthermia Emergency Assistance WeChat-based Group for their assistance in completing the questionnaires. Lingcan Tan and Yi Teng are co-first authors for this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

The project is supported by the National Natural Science Foundation of China (No.72074162) and the 1.3.5. Project for Disciplines of Excellence, West China Hospital, Sichuan University (No. 2018HXFH006).