Korean J Anesthesiol.  2008 Jun;54(6):640-645. 10.4097/kjae.2008.54.6.640.

Reevaluation by Clinical Grading Scale for Malignant Hyperthermia Reported in Korean Journal of Anesthesiology

• Lee JW
• Moon SS
• Lee JR
• Kim DC

• KMID: 1763519
• DOI: http://doi.org/10.4097/kjae.2008.54.6.640

Abstract

BACKGROUND: Malignant hyperthermia (MH) is a disorder of the skeletal muscle manifested as a life threatening hypermetabolic crisis in susceptible individuals following exposure to inhalation anesthetics and depolarizing muscle relaxants. The gold standard for determination of MH susceptibility is the in vitro contracture test (IVCT). However, it is invasive, requiring skeletal muscle biopsy and is not widely available. We attempted to reevaluate the MH in Korea using a Clinical Grading Scale (CGS) developed by Larach and colleagues to assist in clinical diagnosis. We intend to study CGS as a standardized means for estimating the qualitative likelihood of MH and establishing a Korean MH registry system.
METHODS
We obtained twenty-seven case reports from the Korean Journal of Anesthesiology and applied a CGS developed by Larach and colleagues. The raw score of each case was obtained by scoring rules for the MH clinical grading scale, translated to a MH rank, and ranked by the MH likelihood.
RESULTS
The overall mortality rate of reported MH was 44.4%. We described for MH rank and likelihood by CGS of cases. The CGS was missing a process in 13 cases for process II, 5 cases for process III and 4 cases for others.
CONCLUSIONS
MH CGS is useful to aid the objective definition of this disease and for establishing a national registry system.

Keyword

clinical diagnosis; clinical grading scale; malignant hyperthermia

MeSH Terms

Anesthesiology
Anesthetics, Inhalation
Biopsy
Contracture
Korea
Malignant Hyperthermia
Muscle, Skeletal
Neuromuscular Depolarizing Agents
Anesthetics, Inhalation
Neuromuscular Depolarizing Agents