Skip to Main content Skip to Navigation
Journal articles

predictive factors for prognosis after gastrostomy placement in routine non-invasive ventilation users ALS patients

Abstract : Due to the expanding use of non-invasive ventilation (NIV) in amyotrophic lateral sclerosis (ALS), the question of enteral nutrition is increasingly raised in NIV users ALS patients. Here, we aimed to determine the prognostic factors for survival after gastrostomy placement in routine NIV users, taking into consideration ventilator dependence. Ninety-two routine NIV users ALS patients, who underwent gastrostomy insertion for severe dysphagia and/or weight loss, were included. We used a Cox proportional hazards model to identify factors affecting survival and compared time from gastrostomy to death and 30-day mortality rate between dependent (daily use ≥ 16 h) and non-dependent NIV users. The hazard of death after gastrostomy was significantly affected by 3 factors: age at onset (HR 1.047, p = 0.006), body mass index < 20 kg/m2 at the time of gastrostomy placement (HR 2.012, p = 0.016) and recurrent accumulation of airway secretions (HR 2.614, p = 0.001). Mean time from gastrostomy to death was significantly shorter in the dependent than in the non-dependent NIV users group (133 vs. 250 days, p = 0.04). The 30-day mortality rate was significantly higher in dependent NIV users (21.4% vs. 2.8%, p = 0.03). Pre-operative ventilator dependence and airway secretion accumulation are associated with worse prognosis and should be key decision-making criteria when considering gastrostomy tube placement in NIV users ALS patients.
Document type :
Journal articles
Complete list of metadatas

Cited literature [15 references]  Display  Hide  Download

https://hal.sorbonne-universite.fr/hal-02969094
Contributor : Gestionnaire Hal-Su <>
Submitted on : Friday, October 16, 2020 - 12:48:04 PM
Last modification on : Thursday, December 10, 2020 - 3:44:19 AM

File

s41598-020-70422-2.pdf
Publication funded by an institution

Identifiers

Citation

Adèle Hesters, Maria del Mar Amador, Rabab Debs, Nadine Le Forestier, Timothée Lenglet, et al.. predictive factors for prognosis after gastrostomy placement in routine non-invasive ventilation users ALS patients. Scientific Reports, Nature Publishing Group, 2020, 10 (1), pp.15117. ⟨10.1038/s41598-020-70422-2⟩. ⟨hal-02969094⟩

Share

Metrics

Record views

73

Files downloads

32