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Journal article
Clinical prognostic factors predicting survival of motor neuron disease patients with gastrostomy: A retrospective analysis
Muscle & nerve, Vol.69(4), pp.440-447
2024
PMID: 38353364
Abstract
Introduction/Aims
Enteral feeding via gastrostomy is a key intervention to prevent significant weight loss in Motor Neuron Disease (MND). The aim of this study was to explore demographic, clinical, and nutritional factors associated with survival time in MND patients with gastrostomy.
Methods
The retrospective study analyzed 94 MND patients (n = 58 bulbar-onset and n = 36 limb-onset) who underwent gastrostomy between 2015 and 2021. The primary outcome was the survival time from gastrostomy insertion to death. Independent variables of interest explored were: age at gastrostomy insertion, disease onset type, known genetic cause, use of riluzole, non-invasive ventilation (NIV) use, forced vital capacity prior to gastrostomy, weight loss from diagnosis to gastrostomy insertion, and body mass index (BMI) at the time of gastrostomy insertion.
Results
The median survival time from gastrostomy to death was 357 days (± 29.3, 95%CI: 299.5, 414.5). Kaplan–Meier method and log-rank test revealed patients with lower body mass index <18.5 kg/m2 at the time of gastrostomy insertion (p = .023) had shorter survival. Cox proportional hazards model with multivariable adjustment revealed that older age (p = .008), and greater weight loss from diagnosis to gastrostomy (p = .003) were associated with shorter survival time post gastrostomy. Limb onset (p = .023), NIV use not being required (p = .008) and daily NIV use when required and tolerated (p = .033) were associated with longer survival.
Discussion
Preventing or minimizing weight loss from MND diagnosis and encouraging NIV use when clinically indicated are modifiable factors that may prolong the survival of MND patients with gastrostomy.
Details
- Title
- Clinical prognostic factors predicting survival of motor neuron disease patients with gastrostomy: A retrospective analysis
- Authors/Creators
- Jie Yang - Department of Nutrition and Dietetics, Fiona Stanley Hospital, Perth, Western Australia, AustraliaYun Zhao - Curtin School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, AustraliaMario Soares - Curtin School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, AustraliaMerrilee Needham - Murdoch University, Centre for Molecular Medicine and Innovative TherapeuticsAndrea Begley - Curtin School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, AustraliaEmily Calton - South Metropolitan Health Service, Harry Perkins Institute, Perth, Western Australia, Australia
- Publication Details
- Muscle & nerve, Vol.69(4), pp.440-447
- Publisher
- Wiley Periodicals LLC.
- Grant note
- Australian government research training program
- Identifiers
- 991005638868707891
- Copyright
- © 2024 The Authors.
- Murdoch Affiliation
- School of Allied Health
- Language
- English
- Resource Type
- Journal article
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