Amyotrophic lateral sclerosis : mortality and predictors of survival
Year: 2012
Type: dissertation
Study design: Observational Study
Abstract: Amyotrophic lateral sclerosis is a progressive neurodegenerative disorder that leads to destruction of motor neurons, and to death of the patient in less than three years from symptom-onset. Better characterization of the epidemiology of ALS could improve understanding of the disease and lead to etiologic hypotheses, determine whether patterns of occurrence are changing, and show whether distinct phenotypes exist that could be examined for distinct causes. First, we examined the mortality rate from motor neuron disease in France from 1968 to 2007. The crude mortality rate over the study period was 1.74/100,000 person-years, and was higher in men than women. Mortality peaked between 75 and 79 years of age. The Standardized mortality ratio, after indirect standardization for age and gender, increased from 0.54 (95% CI = .49-.59) in 1968 to 1.26 (95% CI =1.20, 1.32) in 2007. The increasing mortality from MND was better explained by a cohort effect, which involves all individuals born at the same time, independent of their age at death, than by a period effect. Changing environmental exposures are a possible explanation for cohort effects, and could be examined in future studies. Next we analyzed survival rates and predictors of survival at the ALS Center, Salpêtrière Hospital, focusing on the survival rate during 2002-2009, and predictors of survival in 1995-2009. No single clinical factor best predicted survival, but a combination of variables (limb-onset, long duration between symptom-onset and first visit, and high muscle strength) were associated with longer survival. The survival rate improved significantly at the center after 2006
Source: HAL
Author: Gordon Gilbert
Language: French
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W192774163