研究背景及目的:
惡性高熱是一種會迅速致命的麻醉急症，但是缺乏合適的流行病學研究方法，以瞭解疾病分布概況，這也使惡性高熱防治措施難以明確規劃。本研究的目的在於: 改善惡性高熱發生率的研究方法，並以此估算台灣地區惡性高熱發生率的特性，以提供未來防治參考。
研究材料與方法:
本研究係以2004至2008年台灣健保資料庫為研究資料，作二手資料分析。惡性高熱病例收集是依據住院醫療費用清單明細檔，以診斷代碼有惡性高熱(ICD-9-CM code 995.86)者，定義為惡性高熱病患，再以病案分析法，討論其準確度。惡性高熱發行率的估算，是以全身麻醉病患為涉險族群；同時使用之前文獻所定義的涉險族群，推估比較發生率差異。死亡率的調查，是依據住院檔的轉歸代碼，找出出院狀態為死亡的病例，計算出惡性高熱死亡率。
研究結果:
台灣惡性高熱流行病學特性如下: <1> 不同的涉險族群定義下，估算之發生率亦有差異。若以所有住院人次為涉險族群，則為每十萬住院人次發生0.3例；若以所有手術人次為涉險族群，則是每十萬手術人次發生0.6例；若以所有麻醉人次為涉險族群，則為每十萬麻醉人次發生0.64例；若以所有全身麻醉人次為涉險族群，則是每十萬全身麻醉人次發生0.97例；若以所有非手術但可能接受麻醉之處置人次為涉險族群，則為每十萬處置人次發生0.85例。<2> 男性發生率遠高於女性。<3> 24歲以下病患，惡性高熱發生率比其他年齡群高，但不同年齡層的發生率無顯著差異。<4> 以全身麻醉為涉險族群作推估，其死亡率大約是12.5%；與2003年相比，死亡率下降。
惡性高熱的行政資料庫分析方法學分析，同一份資料來源，不同定義方式對惡性高熱發生率的估算會產生顯著差異。發生率分子定義方面:診斷碼可辨識出48個惡性高熱住院人次，但經病案分析後，可能是惡性高熱的病案只剩24例，是原始定義方式的一半。發生率分母(涉險族群)的定義方面，以所有將住院病人定為分母，估算出發生率為十萬分之0.3；若是將分母局限在全身麻醉的病患，則估算發生率是十萬分之0.97。兩者呈顯著差異，且後者是前者的三倍。
惡性高熱基本庫存量估算是以各縣市全身麻醉總人次為涉險族群，惡性高熱發生率為十萬分之一，每例至少使用起始劑量6瓶，估算各縣市dantrolene所須的基本儲存量，對照2009年dantrolene全台庫存一覽表，僅七縣市確定達到基本儲備量。然而，若比較北、中、南、東四大區域，則只有一個區域未達基本儲備量。
結論:
以健保資料庫估算台灣惡性高熱大約是十萬分之一，男高於女。死亡率約百分之十二，低於2003年以前。以區域作評估，至少有三區域達到dantrolene基本儲備量；但是，以縣市為單位，則僅七縣市具備基本儲存量。方法學方面，只依據疾病診斷碼收集病案，會產生明顯的偏差。若以住院資料庫欄位，作病案分析整理，可篩選出更符合臨床病程病案。

BACKGROUND: The estimated incidence of malignant hyperthermia (MH) due to anesthesia differs if different denominators of the population at risk are used. The aim of this study was to determine the incidence and mortality of MH in Taiwan using a more suitable denominator, i.e., patients exposed to general anesthesia (GA), based on nationwide population-based data.
METHODS: We used claims data of the National Health Insurance of Taiwan for the years 2004 through 2008 to identify incident patients with MH using ICD-9-CM code 995.86. Besides the four denominators used in a previous study, we added one more suitable denominator, i.e., patients exposed to GA, to calculate the incidence and mortality of MH by sex and age.
RESULTS: The estimated incidence of MH varied by the at-risk group type. The estimated incidences of MH were: 0.3 per 100,000 hospitalizations，0.6 per 100,000 surgical discharge，0.64 per 100,000 hospitalizations with anesthesia procedures，0.97 per 100,000 hospitalizations with general anesthesia，and 0.85 per 100,000 hospitalizations with nonsurgical therapeutic procedures requiring anesthesia .
The incidence in male patients was higher than in female patients. The incidence was highest among male patients aged 0–24 years. When the risk exposure was limited in general anesthesia, the mortality rate was 12.5%.
CONCLUSION: Using claims data of the National Health Insurance in Taiwan, we estimated the incidence of malignant hyperthermia was about one malignant hyperthermia episode per 100,000 hospitalizations with general anesthesia. The incidence decreased with age and males was higher incidence than females. Estimated MH differed greatly according to different denominators used. Further studies are needed to refine denominator to better reflect the real exposure of different trigger agents.

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