Prognostic factors of key outcomes for motor neuron disease in a multiracial Asian population. (February 2020)

• Record Type: Journal Article
• Authors: Deng, Xiao; Hao, Ying; Xiao, Bin; Tan, Eng-King; Lo, Yew-Long
• Is Part Of: Journal of clinical neuroscience. Volume 72(2020)
• Page Start: 63
• Page End: 67
• Publication Date: 2020-02
• Subjects: Survival -- Prognostic factors -- Motor neuron disease -- Asian -- Multiracial; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.01.030
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Our study focused on the spectrum of prognostic factors of key outcomes in Motor neuron disease. A total of 104 MND patients were recruited. We found that bulbar onset was a significant risk predictor for survival, need of feeding support and ventilation aid. Slower disease progression correlated with better outcomes. Age of onset may differ among ethnic groups. Male patients are more likely to develop ALS and have shorter survival duration. Abstract: Background: Knowledge of prognostic factors related to the survival of Motor Neuron Diseases (MND) remains scarce in Southeast Asia. Purpose: To determine potential prognostic factors for survival, need for feeding and ventilation support in MND patients in a multi-racial Asian population. Methods: One hundred and four MND patients from the Singapore General Hospital (SGH) between January 2004 and December 2017 were reviewed. All relevant clinical data, demographic information were collected. Kaplan-Meier and Cox regression model were performed to identify potential prognostic factors for crucial outcomes (survival, need for feeding support and ventilation support). Results: Mean age of onset was 59.54 ± 10.91 years, Mean age of onset in Malays was significantly younger than that of other ethnic groups (Malay: 54.18 ± 12.95 years; Non-Malay: 60.39 ± 10.38 years, p = 0.035). Fifty six of the male and 33of the female were diagnosed with ALS (90.3% vs. 78.6% p = 0.048). Mean overall survival duration from symptom onset was significantly longer in female than male patients (female: 39.2 ± 29.04 months; male: 29.4 ± 24.06 months, P = 0.03). In the multivariable Cox regression model, bulbar onset (aHR = 5.28, p = 0.035) correlated with poor survival outcome while longer duration from onset to second symptom (aHR = 0.96, P = 0.037) indicated better survival. Conclusions: Bulbar onset was a significant risk predictor for survival. Slower disease progression correlated with better outcomes. Age of onset may differ among ethnic groups. Male patients are more likely to develop Amyotrophic Lateral Sclerosis (ALS) and have shorter survival duration.