Amyotrophic Lateral Sclerosis survival analysis: Swallowing and non-oral feeding

NeuroRehabilitation. 2014;35(3):535-42. doi: 10.3233/NRE-141149.

Abstract

Background: Dysphagia-related complications, such as aspiration pneumonia and malnutrition, are major causes of death among patients with Amyotrophic Lateral Sclerosis (ALS).

Objective: To analyze clinical features associated with worsened swallowing and non-oral feeding in ALS.

Methods: This is a long-term study of 33 ALS patients, who were observed between 2006 and 2011 in three month intervals. These subjects underwent Fiberoptic Endoscopic Evaluation of Swallowing and Functional Oral Intake Scale classification. Survival analysis was performed using Cox Regression.

Results: The worsening of swallowing functionality was more rapid in late-onset ALS patients (risk of 4% per year) and individuals with bulbar onset ALS (risk of 188% per year). Non-oral feeding was associated with both the later onset of ALS symptoms (risk of 7.5% per year) and shorter disease duration (risk of 13% per year).

Conclusion: Worsened swallowing was more rapid in individuals who were older at symptoms onset and who had bulbar onset ALS. Non-oral feeding was associated with both age at symptoms onset and shorter disease duration.

Keywords: Amyotrophic Lateral Sclerosis; Dysphagia; deglutition; disease progression; survival analysis.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Age of Onset
  • Aged
  • Amyotrophic Lateral Sclerosis / complications*
  • Amyotrophic Lateral Sclerosis / physiopathology*
  • Amyotrophic Lateral Sclerosis / therapy
  • Deglutition Disorders / etiology*
  • Deglutition Disorders / physiopathology*
  • Deglutition*
  • Disease Progression
  • Endoscopy, Gastrointestinal
  • Enteral Nutrition*
  • Female
  • Humans
  • Laryngeal Diseases / etiology
  • Laryngeal Diseases / physiopathology
  • Male
  • Middle Aged
  • Optical Fibers
  • Pneumonia, Aspiration / etiology
  • Pneumonia, Aspiration / physiopathology
  • Prospective Studies
  • Sex Factors
  • Survival Analysis