Non‐motor manifestations in ALS patients with tracheostomy and invasive ventilation

Nakayama, Yuki; Shimizu, Toshio; Matsuda, Chiharu; Haraguchi, Michiko; Hayashi, Kentarō; Mochizuki, Yoko; Nagao, Masahiro; Kawata, Akihiro; Isozaki, Eiji

doi:10.1002/mus.26004

Cited by 17 publications

(25 citation statements)

References 56 publications

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“…In Italy, a population-based study investigating outcome of tracheostomy in ALS patients showed that the median survival duration after tracheostomy was less than 1 year 7. Conversely, several studies from a single facility reported median survival times of over 3 years following initiation of TIV 12 13…”

Section: Introductionmentioning

confidence: 99%

Prognosis of amyotrophic lateral sclerosis patients undergoing tracheostomy invasive ventilation therapy in Japan

Hayashi

Atsuta

Yokoi

et al. 2020

J Neurol Neurosurg Psychiatry

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ObjectiveThe aim of this study is to describe and clarify the factors affecting the prognosis of Japanese patients with amyotrophic lateral sclerosis (ALS) undergoing tracheostomy invasive ventilation (TIV) therapy.MethodsWe conducted a prospective longitudinal observational case-control study using a multicentre registry. ALS patients who started TIV therapy after registration (TIV group) and those who did not receive TIV (non-TIV group) were included. We compared the survival time between the TIV group and the non-TIV group using a propensity score matching analysis and evaluated the prognostic factors in the TIV group.ResultsFrom February 2006 to January 2018, 190 patients in the TIV group and 1093 patients in the non-TIV group were included in this study. The mean age of disease onset and usage rate of gastrostomy and non-invasive ventilation therapy differed between the groups. In the propensity score matching analysis using known prognostic factors, the median overall survival time of the TIV group was significantly greater than that of the non-TIV group (11.33 years vs 4.61 years; p<0.001). Analysis using the Cox proportional hazard model suggested that older age of onset and respiratory onset was an independent factor for poor prognosis after starting TIV therapy.ConclusionWe showed that there was a significant difference of approximately 7 years in life expectancy between Japanese ALS patients who did and did not receive TIV therapy.

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Section: Introductionmentioning

confidence: 99%

Prognosis of amyotrophic lateral sclerosis patients undergoing tracheostomy invasive ventilation therapy in Japan

Hayashi

Atsuta

Yokoi

et al. 2020

J Neurol Neurosurg Psychiatry

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“…Autonomic abnormalities have sometimes been found in patients with ALS, especially at an advanced stage. 13,28 An experimental report suggested that visceral fat might be increased by sympathetic dysfunction in adipose tissue. 29 TA B L E 4 Correlation between preperitoneal or subcutaneous fat thickness and clinical characteristics woman and long disease duration of the patients in the Mets+ group can be explained by the effect of this hormone.…”

Section: Discussionmentioning

confidence: 99%

“…They indicated that the fat tissue distribution in early ALS appeared similar to what occurs in metabolic syndrome. Moreover, several reports indicated that the frequency of heart failure as a cause of death in patients with ALS with mechanical ventilation is higher than in patients without ventilation . These reports suggest that the existence of the metabolic syndrome may be related to the condition or prognosis of patients with ALS.…”

Section: Introductionmentioning

confidence: 97%

Metabolic syndrome in advanced amyotrophic lateral sclerosis patients with tracheostomy‐invasive ventilation

Nishiyama

Abe

Tokunaga

et al. 2019

Neurology & Clinical Neurosc

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Background Amyotrophic lateral sclerosis (ALS) patients have an energy imbalance. Little is known regarding the association between ALS and metabolic syndrome. Aim We aimed to investigate the clinical characteristics of patients with ALS and the association with metabolic syndrome. Methods We examined the prevalence of metabolic syndrome using the International Diabetes Federation (IDF) diagnostic criteria and analyzed its association with clinical characteristics, including subcutaneous and preperitoneal fat thickness, in 66 patients with ALS who underwent tracheostomy‐invasive ventilation. Results Metabolic syndrome was diagnosed in 29 patients (43.9% of all participants). Metabolic syndrome was more common in women and in those with a longer ALS disease duration, higher body mass index, and higher total serum cholesterol levels. Subcutaneous and preperitoneal fat thickness were significantly higher in patients diagnosed with metabolic syndrome. Conclusion Metabolic syndrome is prevalent among patients with advanced ALS. The hypometabolism in patients receiving mechanical ventilation may be the underlying cause.

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“…The study by Nakayama et al in this issue opens a unique window of opportunity to explore medical changes and complications that impact ALS patients who receive long‐term invasive ventilation . The authors evaluated 67 Japanese ALS patients who are dependent on invasive ventilation, and collected information on 11 predetermined signs, symptoms, and conditions based on the published literature.…”

mentioning

confidence: 99%

“…3 The study by Nakayama et al in this issue opens a unique window of opportunity to explore medical changes and complications that impact ALS patients who receive long-term invasive ventilation. 4 The authors evaluated 67 Japanese ALS patients who are dependent on invasive ventilation, and collected information on 11 predetermined signs, symptoms, and conditions based on the published literature. They divided these changes into 2 main categories: 5 nonmotor manifestation of ALS (macroglossia, unstable blood pressure, hypothermia, urinary catheter placement, hyperglycemia), and 6 complications from invasive ventilation (otitis media, pneumonia, urinary tract infections, cholelithiasis, urinary stones, decubitus ulcers).More than half of the patients needed a urinary catheter and more than 25% of patients had episode of hypothermia, otitis media, and pneumonia.…”

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confidence: 99%