STAC3 Disorder and Malignant Hyperthermia: The Lumbee Native American Tribe of North Carolina

Abstract

Purpose. The purpose of this Doctor of Nursing Practice (DNP) project was to educate anesthesia providers on the STAC3 disorder and its susceptibility to malignant hyperthermia (MH) in the Lumbee Native American tribe through a live education presentation at the North Carolina Association of Nurse Anesthetists (NCANA) Annual Meeting.Background. MH is a hereditary disorder of skeletal muscle that presents as a hypermetabolic response to halogenated anesthetic gasses and/or succinylcholine during anesthesia. The gene RYR1 is the primary site for mutations linked with MH. However, STAC3 disorder, variant p. Trp284Ser, has been identified as a gene linked to MH. STAC3 disorder is estimated to affect 1 in 5,000 Lumbee Tribe members. Increasing anesthesia provider knowledge about the STAC3 disorder in this population can lead to a more tailored anesthesia plan to avoid potential complications. Methods. An anonymous pre-post survey was available after the presentation to volunteer anesthesia providers attending the meeting. Results from the pre-post survey were analyzed with a Wilcoxon Signed Rank test and descriptive analysis measurements to compare the data. Results. The presentation included 50 attendees with up to 28 participants who completed some or all the post survey. The participants included 20 Certified Registered Nurse Anesthetists (CRNAs) and 8 student/resident registered nurse anesthetists. The pre-post survey Likert scale was scored utilizing a five-point scale. The mean, standard deviation, mean difference, median, and p-value were calculated for each matched question. For all pre-post survey questions, there was increased knowledge after the presentation with mean differences ranging from +0.76 to +3.3. For questions pertaining to MH content taught in their CRNA program, participants (n=18, 64%) were not taught about STAC3 disorder during their MH class in their anesthesia program and 16 (57%) individuals reported it was the first time they learned about STAC3 disorder in the Lumbee Tribe. Conclusions. The data analysis demonstrated statistical improvement in STAC3 disorder knowledge and prevalence in the Lumbee Tribe. Most participants are willing to change their anesthesia plan for confirmed or suspected STAC3. Future research is needed to determine other areas in the United States where the Lumbee Tribe reside.