Non-invasive and invasive ventilation and enteral nutrition for ALS in Italy
Copyright © 2014 Wiley Periodicals, Inc., a Wiley company
- Accepted manuscript online: 22 JAN 2014 06:02AM EST
- Manuscript Accepted: 16 JAN 2014
- Manuscript Revised: 10 JAN 2014
- Manuscript Received: 26 JUL 2013
- Palliative Care Specialist
- Emergency and Critical Care Medicine
- Intensive Care Medicine- Anesthesiology
- Cited By
- Amyotrophic lateral sclerosis;
- non-invasive ventilation;
- invasive ventilation;
- enteral nutrition;
- population-based study
Objective: We performed a population-based study to assess amyotrophic lateral sclerosis (ALS) survival after non-invasive ventilation (NIV), invasive ventilation (IV), and enteral nutrition (EN).
Methods: We included patients diagnosed from 2000 to 2009 in Modena, where a prospective registry and a Motor Neuron Diseases (MND) Centre have been active since 2000.
Results: Of the 193 incident cases, 47.7% received NIV, 24.3% received tracheostomy, and 49.2% received EN. A total of 10.4% of the patients refused NIV, 31.6% refused IV, and 8.7% refused EN. The median survival times after NIV, IV, and EN were 15, 19, and 9 months, respectively. Of the tracheostomized patients, 79.7% were discharged from the hospital; 73.0% were discharged to home. The median survival times for tracheostomized patients who were cared for at home and in nursing homes were 43 and 2 months, respectively. The multivariate analysis demonstrated that the place of discharge was the only independent prognostic factor after IV (P<0.01).
Conclusions: Service organizations may promote adherence to NIV, IV, EN and influence post-procedure survival. These data may be useful in defining health plans regarding advanced ALS care and in patient counseling. © 2014 Wiley Periodicals, Inc.