Longitudinal cohort study examines survival and treatment trends in amyotrophic lateral sclerosis, highlighting implications for care.
Key Points
This study examines survival rates and treatment trends associated with home mechanical ventilation in amyotrophic lateral sclerosis over 27 years.
Longitudinal cohort study of 1,360 people with ALS from the Swedish National Registry of Ventilatory Failure (1996–2022)
Utilized multivariable regression models to assess factors influencing mortality and treatment patterns
Analyzed regional variations in invasive and non-invasive ventilation usage.
92% of patients initiated non-invasive ventilation (NIV), while 5% started invasive ventilation (IV) and 3% transitioned from NIV to IV.
Median survival was significantly longer for IV (4.9 years) compared to NIV (1.7 years), and longest for NIV-to-IV transitions (6.5 years), p < 0.001.
Mortality risk was higher with acute IV initiation (aHR 1.26) and was associated with age and female sex; longer time from diagnosis to NIV initiation reduced mortality risk.