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Outcome of patients with amyotrophic lateral sclerosis attending a multidisciplinary care unit.
MedLine Citation:
PMID:  21419529     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a disease with very poor prognosis, and a mortality of 50% at 18 months after diagnosis. Multidisciplinary units attempt to improve the quality of life and survival of patients with ALS. The aim of this study is to evaluate every 3 months, over a 24-month period, the outcome of patients treated at the ALS unit since the time of diagnosis. MATERIAL AND METHODS: We performed a prospective observational study of patients treated in the ALS unit following a clinical pathway since the time of diagnosis with quarterly reviews from 2006 to 2010. The age of onset, functional impairment (ALSFRS-r), impairment of respiratory function, dysphagia and signs of depression and/or cognitive impairment were evaluated in relation to the initial location symptoms (bulbar [B], upper limbs [UL], lower limbs [LL]). RESULTS: A total of 42 patients (30 males and 12 females) were evaluated (mean age at onset of 57.97years old, SD 14.56). There was an even distribution by location of onset of symptoms (B 14 patients, UL 14, LL 14.) Functional impairment (B -26,89 points, UL -22,48 points, LL -22,66 points), the need for use of BIPAP (B 64.28%; UL 35.71%; LL 50%), the presence of dysphagia (B 85.71; UL 42.85; LL 71.42%), signs of depression (B 78.57%; UL 35.71%; LL 64.28%) and cognitive impairment (B 42.85%; UL 21.42; LL 35.71%) was higher at 24 months of progression in patients with bulbar onset. There was no difference in mortality data (23.80% overall). CONCLUSIONS: The treatment in multidisciplinary units does not change the neurological progression of the disease, but increases the survival of ALS patients regardless of their initial onset, emphasising the use of multidisciplinary care.
F J Rodríguez de Rivera; C Oreja Guevara; I Sanz Gallego; B San José Valiente; A Santiago Recuerda; M A Gómez Mendieta; J Arpa; E Díez Tejedor
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-16
Journal Detail:
Title:  Neurologia (Barcelona, Spain)     Volume:  -     ISSN:  0213-4853     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005460     Medline TA:  Neurologia     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.
Unidad de ELA, Servicio de Neurología, Hospital Universitario La Paz, IDIPAZ, Universidad Autónoma de Madrid, Madrid, España.
Vernacular Title:
Evolución de pacientes con esclerosis lateral amiotrófica atendidos una unidad multidisciplinar.
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