Prognosis of amyotrophic lateral sclerosis patients after tracheostomy invasive ventilation in Korea.
Amyotroph Lateral Scler Frontotemporal Degener
; 25(3-4): 271-281, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38340017
ABSTRACT
Background:
Tracheostomy invasive ventilation (TIV) is applied to a subset of amyotrophic lateral sclerosis (ALS) patients; however, its frequency and impact on prognosis vary across countries.Methods:
We conducted a nationwide retrospective cohort study using Korean National Health Insurance claims data. All patients diagnosed with sporadic ALS from 2012 to 2017 were included, with the observation period until 2020. The survival time between the TIV and non-TIV groups was compared using propensity score matching analysis, and prognostic factors were assessed within the TIV group.Results:
This study included 3484 ALS patients (mean [standard deviation] age, 62.4 [11.9] years, 60.4% male), among whom 1230 (35.3%) underwent TIV. After 11 propensity score matching, the survival duration between the two groups was not significantly different (28 vs. 25 months, p = 0.057). Cox regression indicated that older age (hazard ratios [HRs] for each decade compared to <40 years 3.89, 3.83, 5.30, 6.78, and 8.40 [≥80 years]; p < 0.005 for all) and lower income (HR, 1.28; 95% confidence interval [CI], 1.09-1.52; p = 0.003) negatively impacted survival, while gastrostomy (HR, 0.57; 95% CI, 0.50-0.66; p < 0.001) and supportive care services (HR, 0.43; 95% CI, 0.32-0.59; p < 0.001) were associated with prolonged survival.Conclusions:
TIV was administered to more than one-third of Korean ALS patients without significant survival prolongation. Older age, lower income, lack of gastrostomy, and insufficient supportive care were independent poor prognostic factors for survival, underscoring the importance of comprehensive management for ALS patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ventilação não Invasiva
/
Esclerose Lateral Amiotrófica
Tipo de estudo:
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Amyotroph Lateral Scler Frontotemporal Degener
/
Amyotroph. lateral scler. frontotemporal degener. (Online)
/
Amyotrophic lateral sclerosis and frontotemporal degeneration (Online)
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
Reino Unido