TITLE

Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities

AUTHOR(S)
Chiò, A.; Bottacchi, E.; Buffa, C.; Mutani, R.; Mora, G.
PUB. DATE
August 2006
SOURCE
Journal of Neurology, Neurosurgery & Psychiatry;Aug2006, Vol. 77 Issue 8, p948
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. Methods: The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. Results: In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary, ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Conclusions: Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.
ACCESSION #
21992722

 

Related Articles

  • ALS multidisciplinary clinic and survival. Zoccolella, Stefano; Beghi, Ettore; Palagano, Guerrino; Fraddosio, Angela; Guerra, Vito; Lepore, Vito; Simone, Isabella Laura; Lamberti, Paolo; Serlenga, Luigi; Logroscino, Giancarlo // Journal of Neurology;Aug2007, Vol. 254 Issue 8, p1107 

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motorneurons, for which there is no effective cure. Because of the multifactorial nature of impairment and disablity in ALS, multidisciplinary clinics (MDC) have been recently introduced in the management of ALS...

  • Hypermetabolism in ALS patients: an early and persistent phenomenon. Bouteloup, C.; Desport, J.-C.; Clavelou, P.; Guy, N.; Derumeaux-Burel, H.; Ferrier, A.; Couratier, P. // Journal of Neurology;Aug2009, Vol. 256 Issue 8, p1236 

    The malnutrition common among patients with ALS can be attributed in some cases to increased resting energy expenditure (REE). However, the origins and evolution of this hypermetabolism have yet to be fully elucidated. The aim of the present study was to monitor REE over time in patients with...

  • Care for ALS heading in right direction.  // PharmacoEconomics & Outcomes News;11/4/2006, Issue 515, p9 

    The article discusses research being done on the trends in hospital utilization and outcome for patients with amyotrophic lateral sclerosis (AML). It references a study by R. Dubinsky et al published in the September 12, 2006 issue of the journal "Neurology." The study suggests that some aspects...

  • Effect of a multidisciplinary amyotrophic lateral sclerosis (ALS) clinic on ALS survival: a population based study, 1996-2000. Traynor B J; Alexander M; Corr B; Frost E; Hardiman O // Journal of Neurology, Neurosurgery & Psychiatry;Sep2003, Vol. 74 Issue 9, p1258 

    BACKGROUND: In recent years, there has been a paradigm shift in the method of healthcare delivery to amyotrophic lateral sclerosis (ALS) patients with the emergence of multidisciplinary ALS clinics that cater exclusively for patients with this condition. The impact of multidisciplinary...

  • The standard of care in amyotrophic lateral sclerosis: a centralised multidisciplinary clinic encounter sets a new benchmark for a uniquely challenging neurodegenerative disorder. Turner, Martin R.; Kiernan, Matthew C. // Journal of Neurology, Neurosurgery & Psychiatry;May2015, Vol. 86 Issue 5, p481 

    The authors reflect on the variations in the management of neurodegenerative disorder amyotrophic lateral sclerosis (ALS) Patients. They inform about the establishment of the Motor Neurone Disease Association in Wales and Northern Ireland in 1979 that were focused on multidisciplinary approach...

  • MRI findings in a young man with progressive arm weakness. Edmiston, Julie // JAAPA: Journal of the American Academy of Physician Assistants (;Jan2014, Vol. 27 Issue 1, p43 

    No abstract available.

  • Neurología/Psiquiatría. Moneo, María Jesús González; Ramírez, Francisco Buitrago // AMF: Actualización en Medicina de Familia;2010, Vol. 6 Issue 11, p644 

    No abstract available.

  • Prognostic Factors in Amyotrophic Lateral Sclerosis: A Population-Based Study. Moura, Mirian Conceicao; Novaes, Maria Rita Carvalho Garbi; Eduardo, Emanoel Junio; Zago, Yuri S. S. P.; Freitas, Ricardo Del Negro Barroso; Casulari, Luiz Augusto // PLoS ONE;10/30/2015, Vol. 10 Issue 10, p1 

    Objective: To determine the prognostic factors associated with survival in amyotrophic lateral sclerosis at diagnosis. Methods: This retrospective population-based study evaluated 218 patients treated with riluzole between 2005 and 2014 and described their clinical and demographic profiles...

  • THE CRITICAL DECISION--To Intubate or Let Her Die Naturally? Martin, Lawrence // Saturday Evening Post;Jul/Aug95, Vol. 267 Issue 4, p58 

    Presents a narrative concerning a doctor's decision to intubate a patient critically ill with ALS or Lou Gehrig's disease. Consideration of euthanasia.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics