Predictive factors for prognosis following unsedated percutaneous endoscopic gastrostomy in ALS patients
- 21 January 2016
- journal article
- research article
- Published by Wiley in Muscle & Nerve
- Vol. 54 (2), 277-283
- https://doi.org/10.1002/mus.25051
Abstract
Introduction: This study aimed to determine the prognostic factors and the values that predict survival after percutaneous endoscopic gastrostomy (PEG) tube placement in patients with amyotrophic lateral sclerosis (ALS). Methods: We retrospectively analyzed the correlations for 97 consecutive patients with ALS between clinical parameters and survival following PEG tube placement using the log‐rank test and Cox proportional‐hazards models. Results: The log‐rank test showed that an arterial carbon dioxide pressure (PaCO2) of ≤ 40 mmHg (P = 0.0054), a forced vital capacity (FVC) of ≥ 38% of predicted (P = 0.0003), and bulbar‐onset (P = 0.0121) were significantly associated with better post‐PEG survival. Multivariate analysis showed that the FVC and PaCO2 were associated with better post‐PEG survival (P = 0.0081 and P = 0.0265, respectively). Conclusions: PEG tube placement in ALS is recommended when FVC is ≥ 38% of predicted and when PaCO2 is normal. Muscle Nerve 54: 277–283, 2016Funding Information
- Tokyo Metropolitan Institute of Medical Science
- ALS Foundation of the Japan ALS Association
This publication has 27 references indexed in Scilit:
- What is the relevance of percutaneous endoscopic gastrostomy on the survival of patients with amyotrophic lateral sclerosis?Amyotrophic Lateral Sclerosis, 2012
- EFNS guidelines on the Clinical Management of Amyotrophic Lateral Sclerosis (MALS) – revised report of an EFNS task forceEuropean Journal of Neurology, 2011
- Energy metabolism in amyotrophic lateral sclerosisThe Lancet Neurology, 2011
- Noninvasive respiratory muscle aids during PEG placement in ALS patients with severe ventilatory impairmentJournal of the Neurological Sciences, 2010
- Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review)Neurology, 2009
- Prognostic factors in ALS: A critical reviewAmyotrophic Lateral Sclerosis, 2009
- Prospective randomized trial comparing the direct method using a 24 Fr bumper-button-type device with the pull method for percutaneous endoscopic gastrostomyEndoscopy, 2008
- Survival of 793 patients with amyotrophic lateral sclerosis diagnosed over a 28-year periodAmyotrophic Lateral Sclerosis, 2004
- The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory functionJournal of the Neurological Sciences, 1999