title: ALS multidisciplinary clinic and survival. Results from a population-based study in Southern Italy.
abstract: BACKGROUND
  Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motorneurons, for which there is no effective cure. Because of the multifactorial nature of impairment and disablity in ALS, multidisciplinary clinics (MDC) have been recently introduced in the management of ALS patients; their effects on survival remain, however, largely debated.
  
  
  OBJECTIVE
  To compare survival of ALS patients who received their care at MDC with that of patients followed by general neurology clinics.
  
  
  METHODS
  Source of the study was a prospective population-based registry of ALS established in Puglia, Southern Italy, in 1997. We examined survival of 126 out of 130 incident ALS cases that were diagnosed during the period 1998-99.
  
  
  RESULTS
  84 patients (67%) were enrolled and followed by MDC and the remaining 42 (33%) by general neurological clinics. No difference in median survival time from the diagnosis was observed between patients followed by ALS multidisciplinary (17.6 months) and general clinics (18 months). No beneficial effect was present among bulbar onset ALS (11.7 versus 23 months). In multivariate analysis management by ALS MDC was associated with only a 10% increase in survival probability at 12 months (HR: 0.91; 95%CI: 0.44-1.89; p = 0.9).
  
  
  CONCLUSIONS
  In this population-based series, we found that in Southern Italy management of ALS by multidisciplinary clinics does not improve survival, regardless of site of symptoms onset.
authors: Department of Neurological Sciences, University of Bari, Operative Unit of Neurology, L Bonomo Hospital, Andria (BA), Italy.
authors: Stefano
authors: S
authors: Zoccolella
authors: Ettore
authors: E
authors: Beghi
authors: Guerrino
authors: G
authors: Palagano
authors: Angela
authors: A
authors: Fraddosio
authors: Vito
authors: V
authors: Guerra
authors: Vito
authors: V
authors: Lepore
authors: Isabella Laura
authors: IL
authors: Simone
authors: Paolo
authors: P
authors: Lamberti
authors: Luigi
authors: L
authors: Serlenga
authors: Giancarlo
authors: G
authors: Logroscino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology* / Q000401:mortality*; D018672:Community Health Planning; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies