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http://hdl.handle.net/2445/171632
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DC Field | Value | Language |
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dc.contributor.author | Paipa, Andres Julian | - |
dc.contributor.author | Povedano, Mònica | - |
dc.contributor.author | Barceló, Antonia | - |
dc.contributor.author | Domínguez, Raúl | - |
dc.contributor.author | Saez, Marc | - |
dc.contributor.author | Turon, Joana | - |
dc.contributor.author | Prats, Enric | - |
dc.contributor.author | Farrero, Eva | - |
dc.contributor.author | Virgili, Núria | - |
dc.contributor.author | Martínez, Juan Antonio | - |
dc.contributor.author | Corbella, Xavier | - |
dc.date.accessioned | 2020-11-02T10:09:13Z | - |
dc.date.available | 2020-11-02T10:09:13Z | - |
dc.date.issued | 2019-01-01 | - |
dc.identifier.uri | http://hdl.handle.net/2445/171632 | - |
dc.description.abstract | Purpose: Multidisciplinary care has become the preferred model of care for patients with amyotrophic lateral sclerosis (ALS). It is assumed that the sum of interventions associated with this approach has a positive effect on survival. The objective of the study was to evaluate the impact of a multidisciplinary care approach on the survival of patients with ALS. Patients and methods: We performed a retrospective review of prospectively collected data in a tertiary referral center in Spain. Participants were patients with definite or probable ALS managed in a multidisciplinary care program. We compared demographic and survival data of patients with definite or probable ALS treated in a referral center without and with implementation of a multidisciplinary care program. We performed time-dependent multivariate survival analysis of the use of noninvasive mechanical ventilation (NIMV) and gastrostomy. Results: We evaluated 398 consecutive patients, of whom 54 were treated by a general neurologist and 344 were treated in the multidisciplinary care clinic. Patients receiving multidisciplinary care were older (62 vs 58 years), tended to have bulbar onset disease (30% vs 17.7%), and were more likely to receive riluzole (88.7% vs 29.6%, p<0.01), NIMV (48.8% vs 29.6%, p>0.001), and nutrition via gastrostomy (32.3% vs 3.7%, p<0.01). Kaplan-Meier analysis showed a 6-month increase in survival (log-rank, 16.03, p<0.001). Application of the Andersen-Gill model showed that the variables associated with reduced mortality were reduced time to NIMV and gastrostomy and the duration of both, thus reflecting compliance. Conclusions: Multidisciplinary care increased the survival of ALS patients in our study population. Timely use of respiratory support and gastrostomy are fundamental aspects of this benefit. | - |
dc.format.extent | 6 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Dove Medical Press Ltd | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.2147/JMDH.S205313 | - |
dc.relation.ispartof | Journal Of Multidisciplinary Healthcare, 2019-01-01, Vol. 12, P. 465-470 | - |
dc.relation.uri | https://doi.org/10.2147/JMDH.S205313 | - |
dc.rights | cc by-nc (c) Paipa, Andres Julian et al., 2019 | - |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/3.0/es/ | * |
dc.source | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) | - |
dc.subject.classification | Esclerosi lateral amiotròfica | - |
dc.subject.classification | Artificial respiration | - |
dc.subject.classification | Respiració artificial | - |
dc.subject.other | Amyotrophic lateral sclerosis | - |
dc.title | Survival benefit of multidisciplinary care in amyotrophic lateral sclerosis in Spain: association with noninvasive mechanical ventilation | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.date.updated | 2020-10-26T09:27:17Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 31354285 | - |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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PaipaAJ.pdf | 226.11 kB | Adobe PDF | View/Open |
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