Patterns of mortality in patients with motor neurone disease.
OBJECTIVE
Motor neurone disease (MND) is a rapidly fatal condition with survival of less than 4 years. Patients can deteriorate quickly in the preterminal stages resulting in inappropriate resuscitation or admission to intensive care units (ICU) or accident and emergency (A & E).


METHODS
We looked at patterns of mortality with emphasis on the place of death. A retrospective study was performed of all patients attending an MND clinic, who had died within a 10-year period.


RESULTS
Of 179 patients (63 female), 81 patients (45%) died at home, in a hospice or in a nursing home. Sixty-five patients (36%) died in hospital (11 in ICU or A & E). Nine of the latter were previously known to have MND and six admissions were probably avoidable. Most ward patients died of respiratory causes and were treated conservatively.


CONCLUSIONS
The proportion of patients dying in A & E or ICU was small but could have been reduced further. A number of those who died on the wards could probably have been managed conservatively at home. Older patients and those with bulbar disease had a poorer prognosis.
Chaudri
M B
MB
University Hospital, Nottingham, UK. mazhar@chaudri1.freeserve.co.uk
Kinnear
W J M
WJ
Jefferson
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D018447:Medical Futility; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000175:diagnosis / Q000401:mortality*; D012189:Retrospective Studies; D013222:State Medicine / Q000706:statistics & numerical data; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology; D014600:Utilization Review