Tollgate-based progression pathways of ALS patients
| العنوان: | Tollgate-based progression pathways of ALS patients |
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| المؤلفون: | Brian A. Crum, Ozden O. Dalgic, F. Safa Erenay, Kalyan S. Pasupathy, Mustafa Y. Sir, Osman Y. Özaltın |
| المصدر: | Journal of Neurology. 266:755-765 |
| بيانات النشر: | Springer Science and Business Media LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Weakness, Neurology, Severity of Illness Index, Medical Records, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Wheelchair, Swallowing, Humans, Medicine, Longitudinal Studies, 030212 general & internal medicine, Feeding tube, Aged, Neuroradiology, Aged, 80 and over, business.industry, Medical record, Amyotrophic Lateral Sclerosis, Middle Aged, Prognosis, Disease Progression, Breathing, Physical therapy, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery |
| الوصف: | To capture ALS progression in arm, leg, speech, swallowing, and breathing segments using a disease-specific staging system, namely tollgate-based ALS staging system (TASS), where tollgates refer to a set of critical clinical events including having slight weakness in arms, needing a wheelchair, needing a feeding tube, etc. METHODS: We compiled a longitudinal dataset from medical records including free-text clinical notes of 514 ALS patients from Mayo Clinic, Rochester-MN. We derived tollgate-based progression pathways of patients up to a 1-year period starting from the first clinic visit. We conducted Kaplan-Meier analyses to estimate the probability of passing each tollgate over time for each functional segment.At their first clinic visit, 93%, 77%, and 60% of patients displayed some level of limb, bulbar, and breathing weakness, respectively. The proportion of patients at milder tollgate levels (tollgate level 2) was smaller for arm and leg segments (38% and 46%, respectively) compared to others ( 65%). Patients showed non-uniform TASS pathways, i.e., the likelihood of passing a tollgate differed based on the affected segments at the initial visit. For instance, stratified by impaired segments at the initial visit, patients with limb and breathing impairment were more likely (62%) to use bi-level positive airway pressure device in a year compared to those with bulbar and breathing impairment (26%).Using TASS, clinicians can inform ALS patients about their individualized likelihood of having critical disabilities and assistive-device needs (e.g., being dependent on wheelchair/ventilation, needing walker/wheelchair or communication devices), and help them better prepare for future. |
| تدمد: | 1432-1459 0340-5354 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ac6acd9e3de42292506251745661b80e https://doi.org/10.1007/s00415-019-09199-y |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....ac6acd9e3de42292506251745661b80e |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14321459 03405354 |
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