Survival and multidisciplinary amyotrophic lateral sclerosis clinic care at a United States Veterans Affairs medical center

Authors

  • Stephen Rostad MD University of Iowa Hospitals and Clinics https://orcid.org/0000-0001-7337-2970
  • Linder Wendt MS University of Iowa Institute for Clinical and Translational Sciences
  • Mia Poleksic BS University of Iowa, Roy J. and Lucille A. Carver College of Medicine
  • Bryan Hutchinson-Reuss LISW Iowa City Veterans Affairs (VA) Medical Center
  • Heather Bingham MD Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics
  • Deema Fattal MD Department of Neurology, University of Iowa Hospitals and Clinics

DOI:

https://doi.org/10.17161/rrnmf.v5i1.20037

Keywords:

ALS, multidisciplinary, PEG, NIV, edaravone, survival

Abstract

Introduction/Aims: The purpose of this work was to investigate survival outcomes in patients with amyotrophic lateral sclerosis (ALS) at our Veteran’s Affairs Medical Center multidisciplinary ALS clinic and compare this to relevant data from several European studies.

Methods: Our sample consisted of 56 total Veterans (n=56; 54 males, 2 females) that had been seen between June 24, 2013 and February 1, 2021 at our multidisciplinary ALS clinic.

Results: The median survival time of our Veterans from symptom onset was 40.96 months (95% CI of 32.17, 76.07), and the median survival time from diagnosis was 23.77 months (95% CI of 18.64, 38.58). This was consistent with the literature. Further consistent with the literature is that multidisciplinary clinics, including ours, have survival advantage over general neurology clinics. Analyzing factors that contributed to this survival, we found significant protective effect on survival from Edaravone use (HR = 0.32, p = 0.036). Otherwise, there was no significant effect on survival noted from use of percutaneous endoscopic gastrostomy (PEG), non-invasive ventilation (NIV), or Riluzole.

Conclusion: We found no significant difference in survival rates between our U.S. Veterans in our multidisciplinary ALS clinic and European multidisciplinary ALS clinics, and both are better than general neurology clinics. We also found that Edaravone use may provide some benefit to survival in this patient population.

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Author Biographies

  • Linder Wendt MS, University of Iowa Institute for Clinical and Translational Sciences

    Linder Wendt is a Biostatistician for the Institute of Clinical and Translational Science within the University of Iowa Hospitals and Clinics. His primary research interests involve programming in the R language, as well as Machine Learning and various modeling techniques.

  • Mia Poleksic BS, University of Iowa, Roy J. and Lucille A. Carver College of Medicine

    Mia Poleksic is a medical student at the University of Iowa Carver College of Medicine.

  • Bryan Hutchinson-Reuss LISW, Iowa City Veterans Affairs (VA) Medical Center

    Bryan Hutchinson-Reuss is a clinical social worker at the Iowa City VA Medical Center. In addition to providing direct patient care, he also serves as the ALS Clinic Coordinator and the Spinal Cord Injury Coordinator for the Iowa City VA.

  • Heather Bingham MD, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics

    Dr. Heather Bingham is a Clinical Associate Professor of Physical Medicine and Rehabilitation. She works in the Department of Orthopedics and Rehabilitation at the University of Iowa and at the Iowa City VA Medical Center.  She specializes in neurorehabilitation, with a clinical focus on spinal cord injury and ALS.

  • Deema Fattal MD, Department of Neurology, University of Iowa Hospitals and Clinics

    Dr. Deema Fattal is a Clinical Professor of Neurology at the University of Iowa and Chief of Neurology at Iowa City VA Medical Center. She specializes in Neurodegeneration and Balance/Dizziness Disorders and does research in those areas.

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Published

2024-03-01

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Section

New Discoveries and Original Research

How to Cite

Rostad, S., Wendt, L., Poleksic, M., Hutchinson-Reuss, B., Bingham, H., & Fattal, D. (2024). Survival and multidisciplinary amyotrophic lateral sclerosis clinic care at a United States Veterans Affairs medical center. RRNMF Neuromuscular Journal, 5(1). https://doi.org/10.17161/rrnmf.v5i1.20037