Racial differences in intervention rates in individuals with ALS: A case-control study

Neurology. 2019 Apr 23;92(17):e1969-e1974. doi: 10.1212/WNL.0000000000007366. Epub 2019 Mar 27.


Objective: This study was conducted to determine whether longer lifespans in African Americans with amyotrophic lateral sclerosis (ALS), compared to white non-Hispanics, are secondary to higher rates of tracheostomy and invasive ventilation (TIV) in African Americans.

Methods: A retrospective case-control study was conducted with 49 African Americans with ALS matched by age, gender, and site of onset to 137 white persons with ALS.

Results: African Americans had longer survival than whites when the outcome was death (p = 0.016), but this was no longer significant when the outcome was death or TIV (p = 0.100). African Americans also had a lower rate of noninvasive ventilation use compared to whites (27 [55%] vs 96 [70%], p = 0.015) and a higher rate of TIV (8 [16%] vs 7 [5%], p = 0.016), but after controlling for baseline severity, only the noninvasive ventilation difference (p = 0.036), and not the TIV difference (p = 0.115), remained significant.

Conclusion: African Americans with ALS live longer than white persons with ALS, and this may be secondary to higher rates of TIV use among African Americans.

MeSH terms

  • Adult
  • African Americans*
  • Aged
  • Amyotrophic Lateral Sclerosis / mortality
  • Amyotrophic Lateral Sclerosis / therapy*
  • Case-Control Studies
  • European Continental Ancestry Group
  • Female
  • Humans
  • Male
  • Middle Aged
  • Respiration, Artificial*
  • Retrospective Studies
  • Survival Rate
  • Tracheostomy*