Cough peak flow decline rate predicts survival in patients with amyotrophic lateral sclerosis

Muscle Nerve. 2019 Feb;59(2):168-173. doi: 10.1002/mus.26320. Epub 2018 Dec 4.

Abstract

Introduction: In this study we investigated the prognostic significance of cough peak flow (CPF) decline rate in patients with amyotrophic lateral sclerosis (ALS).

Methods: Thirty-four patients with ALS participated in our investigation. We examined CPF, forced vital capacity (FVC), body mass index, and the revised ALS Functional Rating Scale (ALSFRS-R), and followed patients to death, tracheostomy, or non-invasive ventilator dependency. We analyzed the relationship between the rate of decline of each parameter and survival prognosis.

Results: The CPF decline rate significantly correlated with the decline rates of the ALSFRS-R bulbar score (P < 0.0001) and FVC (P < 0.0001). Patients with a CPF decline rate ≥25% had shorter overall survival (P < 0.0001). Cox model multivariate analyses showed that the CPF decline rate was an independent prognostic factor for survival (P = 0.021).

Discussion: The CPF decline rate reflects the progression of bulbar and respiratory dysfunction and predicts survival. Muscle Nerve 59:168-173, 2019.

Keywords: amyotrophic lateral sclerosis; bulbar palsy; cough peak flow; respiratory function; survival prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / complications*
  • Amyotrophic Lateral Sclerosis / mortality*
  • Amyotrophic Lateral Sclerosis / therapy
  • Body Mass Index
  • Cough / etiology*
  • Female
  • Forced Expiratory Flow Rates / physiology*
  • Humans
  • Male
  • Middle Aged
  • Noninvasive Ventilation / methods
  • Retrospective Studies
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Survival Analysis
  • Tracheostomy / methods
  • Vital Capacity / physiology