083 An audit of myasthenia gravis patients at a tertiary neurosciences centre

Abstract

IntroductionThis is the first known audit of Myasthenia Gravis (MG) conducted against the ABN 2015 guidelines. St. George’s Hospital is a tertiary neurosciences centre serving approximately 3 million.MethodsAll patients admitted with a diagnostic code of MG in 2018 were identified (n=59). Data relevant to ABN guidelines were collected from patient records.ResultsAverage time since diagnosis was 7 years (range 0–49). 56% had generalised myasthenia, 25% ocular myasthenia (OMG) and 19% were unspecified. Regarding investigations documented: neurophysi- ology 40%; serotype 58%; thymus imaging 54%; MRI brain 9/14 OMG. Regarding treatment: prednisolone in 61% (6/36 were on a higher than guideline recommended dose to control symptoms); bone protection in 24/36; immunosuppressant in 54%. Immunosuppression was indicated in 2/17 patients who were not on a steroid-sparing agent. Myasthenia was the primary reason for admission in 27/59. 55% of these inpatients had vital capacity monitoring documented. 81% had speech and language therapy.ConclusionThe ABN guidelines are relatively new considering disease duration in this cohort. A signifi- cant limitation is the assumption that if something was not documented in the electronic records, it was not done. A regional MDT has been created this year and re-audit is planned to determine its impact.m1701119@sgul.ac.uk