{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:24:27Z","timestamp":1793384667532,"version":"4.5.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Although some reports link Myasthenia Gravis to higher mortality, the evidence remains contradictory and unclear. Real-life data is limited primarily due to challenges in selecting control groups and mitigating bias. Additionally, a revised mortality assessment should be conducted due to recent advancements in Myasthenia Gravis treatments over the past decade, including new biological therapies and the impact of the COVID-19 pandemic from 2020 to 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of all patients diagnosed with Myasthenia Gravis at our tertiary center between 2000 and 2023, extracting mortality and clinical features compared to two age- and sex-matched control groups of neurological or rheumatologic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 436 Myasthenic patients and 2,616 controls (1308 in each control group). Myasthenia Gravis mortality was 14% at 5 years (61\/422) and 21% at 10 years (87\/422). Mortality was significantly higher than control groups (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Intubations during myasthenic crisis were linked to higher mortality (<jats:italic>p<\/jats:italic> = 0.002). Bulbar weakness at presentation showed higher mortality but did not reach clinical significance. We compared the mean age at death in MG patients to national life expectancy benchmarks using a one-sample Z-test, revealing significantly younger age at death in both males (78.3 vs. 81.6 years, <jats:italic>p<\/jats:italic> = 0.009) and females (76.5 vs. 85.2 years, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001). Patients with normal thymic pathology showed better outcomes and lower mortality after thymic removal (<jats:italic>p<\/jats:italic> &amp;lt; 0.0001). The primary cause of death was linked to infections, significantly correlated with chronic steroid use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In conclusion, patients with Myasthenia Gravis had higher mortality rates. Thymic removal reduced mortality, while intubation is associated with increased mortality risk.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1586031","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:11:24Z","timestamp":1747195884000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Mortality risk in patients with myasthenia gravis"],"prefix":"10.3389","volume":"16","author":[{"given":"Mohamed","family":"Khateb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahar","family":"Shelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S1474-4422(15)00145-3","article-title":"Myasthenia gravis: subgroup classification and therapeutic strategies","volume":"14","author":"Gilhus","year":"2015","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"518","DOI":"10.4103\/neuroindia.NI_804_16","article-title":"Analysis of mortality and related factors in 2195 adult myasthenia gravis patients in a 10-year follow-up study","volume":"65","author":"Liu","year":"2017","journal-title":"Neurol India"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1177\/1941875210382918","article-title":"Myasthenic crisis","volume":"1","author":"Wendell","year":"2011","journal-title":"Neurohospitalist"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1212\/WNL.0b013e3181a41211","article-title":"Incidence and mortality rates of myasthenia gravis and myasthenic crisis in US hospitals","volume":"72","author":"Alshekhlee","year":"2009","journal-title":"Neurology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1002\/mus.20950","article-title":"Lifetime course of myasthenia gravis","volume":"37","author":"Grob","year":"2008","journal-title":"Muscle Nerve"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1136\/jnnp.64.1.78","article-title":"Mortality and survival in myasthenia gravis: a Danish population based study","volume":"64","author":"Christensen","year":"1998","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1016\/j.nmd.2020.08.355","article-title":"Mortality rates and causes of death in Swedish myasthenia gravis patients","volume":"30","author":"Westerberg","year":"2020","journal-title":"Neuromuscul Disord"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1002\/acn3.51792","article-title":"Mortality of myasthenia gravis: a national population-based study in China","volume":"10","author":"Zhang","year":"2023","journal-title":"Ann Clin Transl Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/mus.24697","article-title":"Mortality in myasthenia gravis: A nationwide population-based follow-up study in Denmark","volume":"53","author":"Hansen","year":"2016","journal-title":"Muscle Nerve"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s10238-008-0158-y","article-title":"Myasthenia gravis and the thymus gland. 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