• Muscle & nerve · Aug 2016

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

    • Kota Bokuda, Toshio Shimizu, Kazuhiro Imamura, Akihiro Kawata, Kazuhiko Watabe, Masaharu Hayashi, Yuki Nakayama, Eiji Isozaki, and Imaharu Nakano.
    • Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042.
    • Muscle Nerve. 2016 Aug 1; 54 (2): 277-83.

    IntroductionThis 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).MethodsWe 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.ResultsThe 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).ConclusionsPEG tube placement in ALS is recommended when FVC is ≥ 38% of predicted and when PaCO2 is normal. Muscle Nerve 54: 277-283, 2016.© 2016 Wiley Periodicals, Inc.

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