PROGNOSTIC CATEGORIES FOR AMYOTROPHIC LATERAL SCLEROSIS. (29th November 2012)

• Record Type: Journal Article
• Authors: Scotton, WJ; Scott, KM; Almedom, L; Wijesekera, LC; Janssen, A; Nigro, C; Sakel, M; Leigh, PN; Shaw, C; Al-Chalabi, A
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 83(2012)Supplement 2
• Page Start: A33
• Page End: A33
• Publication Date: 2012-11-29
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2012-304200a.120
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objectives: To generate a prognostic classification method for Amyotrophic Lateral Sclerosis (ALS) from a prognostic model built using clinical variables from a population register. Materials and Methods: We carried out a retrospective multivariate analysis of 713 patients with ALS over a 20 year period from the South-East England Amyotrophic Lateral Sclerosis (SEALS) population register. Patients were randomly allocated to 'discovery' or 'test' cohorts. A prognostic score was calculated using the discovery cohort and then used to predict survival in the test cohort. This score was used as a predictor variable in subsequent survival analyses, either as a raw value for a Cox regression or split into four prognostic categories (good, moderate, average, poor). Results: A prognostic score generated from one cohort of patients predicted survival for a second cohort of patients (r 2 =0.72). Six variables were included in the survival model: age at onset, diagnostic delay, El Escorial category, use of riluzole, gender and site of onset. Cox regression demonstrated a strong relationship between these variables and survival (χ 2 80.8, df 1, p<0.0001, n=343) in the test cohort. Kaplan-Meier analysis demonstrated a significant difference in survival between clinical categories (log rank 161.932, df 3, p<0.001). Conclusion: It is possible to correctly classify patients into prognostic categories using clinical data easily available at time of diagnosis.