RT Journal Article
SR Electronic
T1 Tracheostomy in ALS.Survival and related factors
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3583
DO 10.1183/13993003.congress-2021.PA3583
VO 58
IS suppl 65
A1 Cristina Gomez Rebollo
A1 María Melgar Herrero
A1 Estefanía Mira Padilla
A1 Cristina Muñoz Corroto
A1 Pablo García Lovera
A1 Natalia Pascual Martínez
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/PA3583.abstract
AB In ALS with established respiratory failure, patients may benefit from the use of tracheostomy. There are few studies regarding the survival of these patients and related prognostic factors.Aims: To evaluate survival and factors related to the presence of tracheostomy in ALS patients. To analyze prognostic factors for survival.Methods: Observational and retrospective study(January 2005-February 2021)in ALS patients under follow-up by Pneumology. The following variables were recorded:age, sex,time since diagnosis, onset of symptoms, type of ALS, use of NIV, use of cough assistant, percutaneous gastrostomy, hospitalizations,days of stay and tracheostomy. Data were analyzed by Chi-square, U-Mann-Whitney, Kaplan-Meier, Spearman's Rho and Cox regression.Results: 218 patients were included, mean age 63.4+/-12.9years, 53.1%male, 81.9%sporadic ALS and 58.4%spinal ALS.Some 5.1%had tracheostomy, associated with the use of life support ventilation[OR=14.4(95%CI 1.8-116.2)],gastrostomy[OR=15.7(95%CI 1.9-125.0)],younger age at diagnosis(47.4±14.9years),higher number of admissions(2.6±1.7)and hospital stay(85.2±118.7days)p>0.005.There were no significant differences in tracheostomy survival(32.7±11.8months)and overall cohort survival(40.8±7.8months).In the univariate and subsequent multivariate analysis, the overall survival of patients is related to age at diagnosis and bulbar onset(HR=1.05 p<0.001 and HR=1.6 p=0.028).Conclusions: In our study, the use of tracheostomy does not improve survival over the remaining patients who refuse it. Tracheostomy is related with patients who presented continuous use of NIV, need for gastrostomy and higher number of admissions and hospital stay. Age at diagnosis and bulbar form are considered prognostic factors for survival.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3583.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).