2026-04-13T04:51:20Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1716322025-12-05T12:41:30Zcom_2072_1057col_2072_478916col_2072_478917

urn:hdl:2445/171632 Survival benefit of multidisciplinary care in amyotrophic lateral sclerosis in Spain: association with noninvasive mechanical ventilation Paipa, Andres Julian Povedano, Mònica Barceló, Antonia Domínguez, Raúl Saez, Marc Turon, Joana Prats, Enric Farrero, Eva Virgili, Núria Martínez, Juan Antonio Corbella, Xavier Esclerosi lateral amiotròfica Artificial respiration Respiració artificial Amyotrophic lateral sclerosis Purpose: Multidisciplinary care has become the preferred model of care for patients with amyotrophic lateral sclerosis (ALS). It is assumed that the sum of interventions associated with this approach has a positive effect on survival. The objective of the study was to evaluate the impact of a multidisciplinary care approach on the survival of patients with ALS. Patients and methods: We performed a retrospective review of prospectively collected data in a tertiary referral center in Spain. Participants were patients with definite or probable ALS managed in a multidisciplinary care program. We compared demographic and survival data of patients with definite or probable ALS treated in a referral center without and with implementation of a multidisciplinary care program. We performed time-dependent multivariate survival analysis of the use of noninvasive mechanical ventilation (NIMV) and gastrostomy. Results: We evaluated 398 consecutive patients, of whom 54 were treated by a general neurologist and 344 were treated in the multidisciplinary care clinic. Patients receiving multidisciplinary care were older (62 vs 58 years), tended to have bulbar onset disease (30% vs 17.7%), and were more likely to receive riluzole (88.7% vs 29.6%, p<0.01), NIMV (48.8% vs 29.6%, p>0.001), and nutrition via gastrostomy (32.3% vs 3.7%, p<0.01). Kaplan-Meier analysis showed a 6-month increase in survival (log-rank, 16.03, p<0.001). Application of the Andersen-Gill model showed that the variables associated with reduced mortality were reduced time to NIMV and gastrostomy and the duration of both, thus reflecting compliance. Conclusions: Multidisciplinary care increased the survival of ALS patients in our study population. Timely use of respiratory support and gastrostomy are fundamental aspects of this benefit. 2020-11-02T10:09:13Z 2020-11-02T10:09:13Z 2019-01-01 2020-10-26T09:27:17Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.2147/JMDH.S205313 Journal Of Multidisciplinary Healthcare, 2019-01-01, Vol. 12, P. 465-470 https://doi.org/10.2147/JMDH.S205313 cc by-nc (c) Paipa, Andres Julian et al., 2019 http://creativecommons.org/licenses/by-nc/3.0/es/ info:eu-repo/semantics/openAccess Dove Medical Press Ltd Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))