Predictive factors for prognosis following unsedated percutaneous endoscopic gastrostomy in ALS patients

Muscle Nerve. 2016 Aug;54(2):277-83. doi: 10.1002/mus.25051.

Abstract

Introduction: This study aimed to determine the prognostic factors and the values that predict survival after percutaneous endoscopic gastrostomy (PEG) tube placement in patients with amyotrophic lateral sclerosis (ALS).

Methods: We retrospectively analyzed the correlations for 97 consecutive patients with ALS between clinical parameters and survival following PEG tube placement using the log-rank test and Cox proportional-hazards models.

Results: The log-rank test showed that an arterial carbon dioxide pressure (PaCO2 ) of ≤ 40 mmHg (P = 0.0054), a forced vital capacity (FVC) of ≥ 38% of predicted (P = 0.0003), and bulbar-onset (P = 0.0121) were significantly associated with better post-PEG survival. Multivariate analysis showed that the FVC and PaCO2 were associated with better post-PEG survival (P = 0.0081 and P = 0.0265, respectively).

Conclusions: PEG tube placement in ALS is recommended when FVC is ≥ 38% of predicted and when PaCO2 is normal. Muscle Nerve 54: 277-283, 2016.

Keywords: amyotrophic lateral sclerosis; arterial carbon dioxide pressure; enteral nutrition; forced vital capacity; percutaneous endoscopic gastrostomy; prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis / diagnosis*
  • Body Mass Index
  • Body Weight
  • Endoscopy / methods*
  • Enteral Nutrition
  • Female
  • Gastrostomy / methods*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Statistics, Nonparametric
  • Vital Capacity