Body weight variation predicts disease progression after invasive ventilation in amyotrophic lateral sclerosis
Year: 2019
Type: article
Study design: Observational Study
Abstract: Weight loss is an independent predictor of survival in the early stages of amyotrophic lateral sclerosis (ALS). However, the effects of weight variations on the functional prognosis after tracheostomy and invasive ventilation (TIV) in ALS remain unknown. This prospective cohort study aimed to investigate the relationship between weight loss before TIV and disease progression after TIV in ALS patients. Sixty ALS patients with TIV were enrolled and classified into subgroups based on the rate of decline in body mass index, from onset to TIV utilization (ΔBMI). During follow-up, we assessed the patients for presence of communication impairments, ophthalmoplegia, total quadriplegia, mouth opening disability, and dysuria. We analyzed the relationship between ΔBMI and the communication stage or motor disabilities. The log-rank test showed that patients with a ΔBMI ≥ 1.7 kg/m2/year showed a shorter period of preserved communication ability (p = 0.0001), shorter time to develop ophthalmoplegia (p = 0.0001), total quadriplegia (p < 0.0001), mouth opening disability (p < 0.0001), and dysuria (p = 0.0455). Cox multivariate analyses showed that a larger ΔBMI was an independent prognostic factor for the early development of ophthalmoplegia (p = 0.0400) and total quadriplegia (p = 0.0445). Weight loss in the early stages of ALS predicts disease progression in patients with advanced stages of ALS using TIV.
Source: Scientific Reports
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,790
Awards: G1245349869, G3088087024, Developing an index of risk management by collaboration between hospital nurses and home visiting nurses in home care setting, Selection criteria for airway clearance care based on the evaluation of bulbar symptom and respiratory function in Amyotrophic Lateral Sclerosis, Assessment of energy expenditure and muscle mass using stable isotope among patients with neuromuscular diseases and frail elderly, Mixed methods evaluation of a standardized dual-monitoring telenursing system and development of a telenursing education program, Pathological characterization of amyotrophic lateral sclerosis symptoms comorbid with motor nerve degeneration to establish best practices for nursing care, Challenging to conquer Totally Locked-in State in people with ALS Tracheostomy ventilation; Developing an innovate communication support device and nursing care, G7956392602, Development of an innovative communication support device for amyotrophic lateral sclerosis based on the underlying pathophysiology and long-term follow-up assessment
OpenAlex ID: W2969575148