Non-invasive ventilation in amyotrophic lateral sclerosis: a 10 year population based study.
OBJECTIVE
To evaluate the clinical characteristics and outcome of non-invasive ventilation (NIV) in an epidemiological based series of amyotrophic lateral sclerosis (ALS) patients.


METHODS
The study was performed using data from the Piemonte and Valle d'Aosta Register for ALS, a prospective epidemiological register enrolling all ALS incident cases in two Italian regions.


RESULTS
Among the 1260 patients incident in the period 1995-2004, 259 (20.6%) underwent NIV. Young male patients and subjects attending the tertiary ALS centres were more likely to undergo NIV. There was a progressive significant increase in the use of NIV during the study but was limited to patients attending the ALS tertiary centres. Median survival after NIV was 289 days (95% CI 255 to 333).


CONCLUSIONS
In an epidemiological setting, NIV represents an increasingly utilised option for the treatment of respiratory disturbances in ALS and has favourable effects on survival, in particular among patients followed by tertiary ALS centres. Sociocultural factors, such as age, gender and marital status, strongly influence the probability of undergoing NIV. Efforts should be made to remove these obstacles in order to spread the use of NIV in all ALS patients with respiratory failure.
ALS Centre, Department of Neuroscience, University of Torino, Via Cherasco 15, Torino 10126, Italy. achio@usa.net
Adriano
A
Chiò
Andrea
A
Calvo
Cristina
C
Moglia
Federica
F
Gamna
Alessio
A
Mattei
Letizia
L
Mazzini
Gabriele
G
Mora
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000401:mortality / Q000628:therapy*; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000706:statistics & numerical data*; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012131:Respiratory Insufficiency / Q000401:mortality / Q000517:prevention & control; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D055512:Tertiary Prevention