Tracheostomy in amyotrophic lateral sclerosis: a 10-year population-based study in Italy.

Abstract

We evaluated the clinical characteristics and outcome of tracheostomy in amyotrophic lateral sclerosis (ALS) using data from the Piemonte and Valle d'Aosta Register for ALS, a prospective epidemiological register collecting all ALS incident cases in two Italian regions. Among the 1260 patients incident in the period 1995-2004, 134 (10.6%) underwent tracheostomy. Young male patients were more likely to be tracheostomised. Site of onset (bulbar vs spinal) and period of diagnosis (1995-1999 vs 2000-2004) did not influence the likelihood of being tracheostomised. The mean duration of hospital stay was 52.0 days (SD 60.5). Overall, 27 patients died while still in hospital (20.1%). Sixty-five patients (48.5%) were discharged to home, whereas 42 (31.3%) were admitted to long-term care facilities. The median survival time after tracheostomy was 253 days. In the Cox multivariable model, the factors independently related to a longer survival were enteral nutrition, age, marital status and ALS centre follow-up. In conclusion, in an epidemiological setting, ALS survival after tracheostomy was <1 year. Sociocultural factors influence the probability of choice to be tracheostomised, even in a highly socialized health system as Italian one.

• Authors: A Chiò, A Calvo, P Ghiglione, L Mazzini, R Mutani, G Mora, PARALS
• Journal: Journal of neurology, neurosurgery, and psychiatry (J Neurol Neurosurg Psychiatry) Vol. 81 Issue 10 Pg. 1141-3 (Oct 2010) ISSN: 1468-330X [Electronic] England
• PMID: 20660920 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Amyotrophic Lateral Sclerosis (mortality, surgery)
• Female
• Follow-Up Studies
• Humans
• Italy
• Male
• Middle Aged
• Proportional Hazards Models
• Survival Rate (trends)
• Tracheostomy (mortality, statistics & numerical data)
• Treatment Outcome