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dc.contributor.authorLechtzin, Noah
dc.contributor.authorWiener, Charles M.
dc.contributor.authorClawson, Lora
dc.contributor.authorDavidson, Matthew C.
dc.contributor.authorAnderson, Frederick A. Jr.
dc.contributor.authorGowda, Neelam
dc.contributor.authorDiette, Gregory B.
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:28Z
dc.date.available2022-08-23T15:43:28Z
dc.date.issued2004-03-19
dc.date.submitted2011-09-16
dc.identifier.citationAmyotroph Lateral Scler Other Motor Neuron Disord. 2004 Mar;5(1):9-15. <a href="http://dx.doi.org/10.1080/14660820310017335">Link to article on publisher's site</a>
dc.identifier.issn1466-0822 (Linking)
dc.identifier.doi10.1080/14660820310017335
dc.identifier.pmid15204018
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27100
dc.description.abstractINTRODUCTION: Noninvasive positive pressure ventilation (NIPPV) is associated with improved survival in amyotrophic lateral sclerosis (ALS) and has been widely recommended. The extent of NIPPV use in ALS patients and the factors associated with its use have not been studied. METHODS: A cross-sectional study using the ALS Patient Care Database. Analyses were performed to assess the association of patient and care characteristics with use of ventilatory support. RESULTS: 1458 patients were studied. 15.6% used NIPPV and 2.1% used invasive mechanical ventilation. Patients who used NIPPV were significantly more likely to be male and have higher income than those who did not. They were also more likely to have a gastrostomy tube, lower vital capacity, more severe disease, bulbar involvement and poorer general health status as measured by the SF-12 and Sickness Impact Profile. Multivariate analysis revealed that lower FVC, higher income and use of gastrostomy tube were independently associated with use of NIPPV. CONCLUSIONS: NIPPV is used more than seven times as frequently as invasive ventilation in ALS patients. Patients who use NIPPV have more severe disease than those who do not use any respiratory intervention. Patients with lower income are less likely to use NIPPV, which raises concerns about disparities in the care of patients with ALS.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=15204018&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1080/14660820310017335
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAge Factors
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAmyotrophic Lateral Sclerosis
dc.subjectCross-Sectional Studies
dc.subjectDemography
dc.subjectFemale
dc.subjectHumans
dc.subjectIntermittent Positive-Pressure Ventilation
dc.subjectnumerical data
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRetrospective Studies
dc.subjectSex Factors
dc.subjectSickness Impact Profile
dc.subjectSocial Support
dc.subjectSocioeconomic Factors
dc.subjectSurvival Analysis
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectHealth Services Research
dc.titleUse of noninvasive ventilation in patients with amyotrophic lateral sclerosis
dc.typeJournal Article
dc.source.journaltitleAmyotrophic lateral sclerosis and other motor neuron disorders : official publication of the World Federation of Neurology, Research Group on Motor Neuron Diseases
dc.source.volume5
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_als/2
dc.identifier.contextkey2241834
html.description.abstract<p>INTRODUCTION: Noninvasive positive pressure ventilation (NIPPV) is associated with improved survival in amyotrophic lateral sclerosis (ALS) and has been widely recommended. The extent of NIPPV use in ALS patients and the factors associated with its use have not been studied.</p> <p>METHODS: A cross-sectional study using the ALS Patient Care Database. Analyses were performed to assess the association of patient and care characteristics with use of ventilatory support.</p> <p>RESULTS: 1458 patients were studied. 15.6% used NIPPV and 2.1% used invasive mechanical ventilation. Patients who used NIPPV were significantly more likely to be male and have higher income than those who did not. They were also more likely to have a gastrostomy tube, lower vital capacity, more severe disease, bulbar involvement and poorer general health status as measured by the SF-12 and Sickness Impact Profile. Multivariate analysis revealed that lower FVC, higher income and use of gastrostomy tube were independently associated with use of NIPPV.</p> <p>CONCLUSIONS: NIPPV is used more than seven times as frequently as invasive ventilation in ALS patients. Patients who use NIPPV have more severe disease than those who do not use any respiratory intervention. Patients with lower income are less likely to use NIPPV, which raises concerns about disparities in the care of patients with ALS.</p>
dc.identifier.submissionpathcor_als/2
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages9-15


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