title: Risk factors for respiratory failure of motor neuron disease in a multiracial Asian population.
abstract: BACKGROUND
  Motor neuron disease (MND) is a devastating degenerative disorder. Amyotrophic Lateral Sclerosis (ALS) is the most common and severe form of MND. Respiratory failure arising from ventilator musculature atrophy is the most common cause of death for ALS patients. Exploring the factors correlated with respiratory failure can contribute to disease management.
  
  
  OBJECTIVE
  To characterize the clinical features of MND and determine the factors that may affect respiratory failure of MND patients.
  
  
  METHODS
  The case records of all MND patients seen in Singapore General Hospital (SGH) between January 2004 and December 2014 were examined. Demographic, clinical information were collected by reviewing case records. Mortality data, if not available from records, were obtained via phone call interview of family members. Demographic data and clinical treatments were compared between Respiratory support group and Non-respiratory support group.
  
  
  RESULTS
  There were 73 patients included in our study. 49 (67.1%) patients died during follow-up. The mean age of onset was 58±11.1years. With regard to treatment, 63% needed feeding support, and 42.5% required ventilation aid. The median overall survival was 36months from symptom onset. Chi-square tests showed there was significantly higher percentage of respiratory support needed in Chinese than in other races (P=0.016). Compared with non-feeding support patients, patients with feeding support were more likely to require assisted ventilation (P=0.001).
  
  
  CONCLUSIONS
  We report for the first time that the need of feeding support is significantly associated with assisted ventilation. Chinese MND patients may be more inclined to require respiratory support.
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Xiao
authors.initials: X
authors.lastname: Deng
authors.affiliation: Health Service Research Unit, Division of Medicine, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Ying
authors.initials: Y
authors.lastname: Hao
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Bin
authors.initials: B
authors.lastname: Xiao
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore 169608, Singapore; Duke-NUS Graduate Medical School, Singapore 169857, Singapore.
authors.forename: Eng-King
authors.initials: EK
authors.lastname: Tan
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore 169608, Singapore; Duke-NUS Graduate Medical School, Singapore 169857, Singapore. Electronic address: lo.yew.long@singhealth.com.sg.
authors.forename: Yew-Long
authors.initials: YL
authors.lastname: Lo
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000175:diagnosis / Q000208:ethnology; D044466:Asian People / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology*; D011159:Population Surveillance; D044469:Racial Groups / Q000208:ethnology*; D012131:Respiratory Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology*; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000208:ethnology
keywords: Asian; Motor neuron disease; Multiracial; Prognostic factors; Respiratory failure