Poor Prognostic Factors After Gastrostomy in Patients With Amyotrophic Lateral Sclerosis: A Two-Center Retrospective...

Area of Science:

• Neurology
• Gastroenterology
• Pulmonology

Background:

• Percutaneous endoscopic gastrostomy (PEG) is a common intervention for dysphagia in amyotrophic lateral sclerosis (ALS).
• However, outcomes post-PEG vary, with some patients experiencing rapid clinical decline.
• Predictors of post-PEG outcomes in ALS patients require further definition.

Purpose of the Study:

• To identify independent prognostic factors influencing outcomes after PEG placement in patients with ALS.
• To define optimal cutoff values for key clinical variables associated with post-PEG prognosis.

Main Methods:

• A retrospective cohort study of 117 ALS patients who underwent PEG prior to tracheostomy.
• Cox proportional hazards modeling and time-dependent receiver operating characteristic analyses were employed.
• Key variables included age, sex, onset site, forced vital capacity (%FVC), disease duration, and body mass index.

Main Results:

• Male sex, spinal onset, %FVC < 63%, and disease duration < 12 months were independently associated with worse post-PEG outcomes.
• Log-rank analyses confirmed significantly shorter survival in patients meeting these criteria.
• These factors highlight critical thresholds for predicting PEG outcomes.

Conclusions:

• Reduced respiratory function (%FVC) and shorter disease duration to PEG are strong indicators of poorer prognosis in ALS patients.
• Male sex is an independent prognostic factor, possibly reflecting biological differences in disease progression.
• Comprehensive clinical assessment is crucial when considering PEG for ALS patients.