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dc.contributor.authorMitsumoto, H.
dc.contributor.authorDavidson, Matthew C.
dc.contributor.authorMoore, D.
dc.contributor.authorGad, N.
dc.contributor.authorBrandis, M.
dc.contributor.authorRingel, S.
dc.contributor.authorRosenfeld, J.
dc.contributor.authorShefner, J. M.
dc.contributor.authorStrong, M. J.
dc.contributor.authorSufit, R.
dc.contributor.authorAnderson, Frederick A. Jr.
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:28Z
dc.date.available2022-08-23T15:43:28Z
dc.date.issued2003-09-18
dc.date.submitted2011-09-16
dc.identifier.citationAmyotroph Lateral Scler Other Motor Neuron Disord. 2003 Sep;4(3):177-85.
dc.identifier.issn1466-0822 (Linking)
dc.identifier.pmid13129795
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27102
dc.description.abstractOBJECTIVE: To compare characteristics of ALS patients with and without percutaneous endoscopic gastrostomy (PEG). METHODS: Using the ALS Patient Care Database, data from patients with and without PEG with ALS Functional Rating Scale-bulbar subscale (ALSFRSb) scores < or = 5 were analyzed; follow-up data were also collected. RESULTS: PEG use was markedly increased with declining ALSFRSb scores. Demographics did not differ, but ALSFRS composite scores and bulbar and arm subscale scores were lower (P<0.0001). PEG patients used significantly more assistive devices, multidisciplinary care, home care nurses and aides, had more frequent physician and emergency department visits and hospital admissions (P<0.0001), and had lower health status based on the mini-SIP scale (P=0.0047). PEG use varied greatly between ALS centers. In the follow-up study, positive impact of PEG was noted in 79 % of PEG patients but in only 37.5% of patients who received PEG later, based on a small number of patients. PEG use showed no survival benefit. CONCLUSION: Patients did not receive PEG until bulbar function was severely reduced and overall ALS had markedly progressed. PEG may have been performed too late to demonstrate survival benefits. Aggressive proactive nutritional management appears essential in patients with ALS. To determine whether PEG provides benefits, it must be performed at earlier stages of the disease and prospectively studied.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=13129795&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1080/14660820310011728
dc.subjectAmyotrophic Lateral Sclerosis
dc.subjectBulbar Palsy, Progressive
dc.subjectDatabases as Topic
dc.subjectDisability Evaluation
dc.subjectEndoscopy
dc.subjectEnteral Nutrition
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectGastrostomy
dc.subjectHealth Care Surveys
dc.subjectHome Care Services
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectSurvival Rate
dc.subjectTreatment Outcome
dc.subjectHealth Services Research
dc.titlePercutaneous endoscopic gastrostomy (PEG) in patients with ALS and bulbar dysfunction
dc.typeArticle
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.volume4
dc.source.issue3
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_als/4
dc.identifier.contextkey2241836
html.description.abstract<p>OBJECTIVE: To compare characteristics of ALS patients with and without percutaneous endoscopic gastrostomy (PEG).</p> <p>METHODS: Using the ALS Patient Care Database, data from patients with and without PEG with ALS Functional Rating Scale-bulbar subscale (ALSFRSb) scores < or = 5 were analyzed; follow-up data were also collected.</p> <p>RESULTS: PEG use was markedly increased with declining ALSFRSb scores. Demographics did not differ, but ALSFRS composite scores and bulbar and arm subscale scores were lower (P<0.0001). PEG patients used significantly more assistive devices, multidisciplinary care, home care nurses and aides, had more frequent physician and emergency department visits and hospital admissions (P<0.0001), and had lower health status based on the mini-SIP scale (P=0.0047). PEG use varied greatly between ALS centers. In the follow-up study, positive impact of PEG was noted in 79 % of PEG patients but in only 37.5% of patients who received PEG later, based on a small number of patients. PEG use showed no survival benefit.</p> <p>CONCLUSION: Patients did not receive PEG until bulbar function was severely reduced and overall ALS had markedly progressed. PEG may have been performed too late to demonstrate survival benefits. Aggressive proactive nutritional management appears essential in patients with ALS. To determine whether PEG provides benefits, it must be performed at earlier stages of the disease and prospectively studied.</p>
dc.identifier.submissionpathcor_als/4
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages177-85


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