Gastrostomy in patients with amyotrophic lateral sclerosis (ProGas): a prospective cohort study
dc.contributor.author | McDermott, CJ | |
dc.contributor.author | Shaw, PJ | |
dc.contributor.author | Stavroulakis, T | |
dc.contributor.author | Walters, SJ | |
dc.contributor.author | Al-Chalabi, A | |
dc.contributor.author | Chandran, S | |
dc.contributor.author | Crawley, F | |
dc.contributor.author | Dick, D | |
dc.contributor.author | Donaghy, C | |
dc.contributor.author | Eames, P | |
dc.contributor.author | Fish, M | |
dc.contributor.author | Gent, C | |
dc.contributor.author | Gorrie, G | |
dc.contributor.author | Hamdalla, H | |
dc.contributor.author | Hanemann, Clemens Oliver | |
dc.contributor.author | Johnson, M | |
dc.contributor.author | Majeed, T | |
dc.contributor.author | Malaspina, A | |
dc.contributor.author | Morrison, K | |
dc.contributor.author | Orrell, R | |
dc.contributor.author | Pinto, A | |
dc.contributor.author | Radunovic, A | |
dc.contributor.author | Roberts, M | |
dc.contributor.author | Talbot, K | |
dc.contributor.author | Turner, MR | |
dc.contributor.author | Williams, T | |
dc.contributor.author | Young, C | |
dc.contributor.author | Grp, PS | |
dc.date.accessioned | 2018-05-08T09:29:28Z | |
dc.date.issued | 2015-07 | |
dc.identifier.issn | 1474-4422 | |
dc.identifier.issn | 1474-4465 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/11410 | |
dc.description.abstract |
BACKGROUND: Gastrostomy feeding is commonly used to support patients with amyotrophic lateral sclerosis who develop severe dysphagia. Although recommended by both the American Academy of Neurology and the European Federation of Neurological Societies, currently little evidence indicates the optimum method and timing for gastrostomy insertion. We aimed to compare gastrostomy insertion approaches in terms of safety and clinical outcomes. METHODS: In this large, longitudinal, prospective cohort study (ProGas), we enrolled patients with a diagnosis of definite, probable, laboratory supported, or possible amyotrophic lateral sclerosis who had agreed with their treating clinicians to undergo gastrostomy at 24 motor neuron disease care centres or clinics in the UK. The primary outcome was 30-day mortality after gastrostomy. This study was registered on the UK Clinical Research Network database, identification number 9923. FINDINGS: Between Nov 2, 2010, and Jan 31, 2014, 345 patients were recruited of whom 330 had gastrostomy. 163 (49%) patients underwent percutaneous endoscopic gastrostomy, 121 (37%) underwent radiologically inserted gastrostomy, 43 (13%) underwent per-oral image-guided gastrostomy, and three (1%) underwent surgical gastrostomy. 12 patients (4%, 95% CI 2·1-6·2) died within the first 30 days after gastrostomy: five (3%) of 163 after percutaneous endoscopic gastrostomy, four (3%) of 121 after radiologically inserted gastrostomy, and three (7%) of 43 after per-oral image-guided gastrostomy (p=0·46). Including repeat attempts in 14 patients, 21 (6%) of 344 gastrostomy procedures could not be completed: 11 (6%) of 171 percutaneous endoscopic gastrostomies, seven (6%) of 121 radiologically inserted gastrostomies, and three (6%) of 45 per-oral image-guided gastrostomies (p=0·947). INTERPRETATION: The three methods of gastrostomy seemed to be as safe as each other in relation to survival and procedural complications. In the absence of data from randomised trials, our findings could inform clinicians and patients in reaching decisions about gastrostomy and will stimulate further research into the nutritional management in patients with amyotrophic lateral sclerosis. FUNDING: Motor Neurone Disease Association of Great Britain and Northern Ireland (MNDA) and the Sheffield Institute for Translational Neuroscience (SITraN). | |
dc.format.extent | 702-709 | |
dc.format.medium | Print-Electronic | |
dc.language | en | |
dc.language.iso | eng | |
dc.publisher | Elsevier BV | |
dc.subject | Aged | |
dc.subject | Amyotrophic Lateral Sclerosis | |
dc.subject | Cohort Studies | |
dc.subject | Enteral Nutrition | |
dc.subject | Female | |
dc.subject | Gastrostomy | |
dc.subject | Humans | |
dc.subject | Longitudinal Studies | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Prospective Studies | |
dc.subject | Survival Rate | |
dc.subject | United Kingdom | |
dc.title | Gastrostomy in patients with amyotrophic lateral sclerosis (ProGas): a prospective cohort study | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Multicenter Study | |
dc.type | Research Support, Non-U.S. Gov't | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000356195900020&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 7 | |
plymouth.volume | 14 | |
plymouth.publication-status | Published | |
plymouth.journal | The Lancet Neurology | |
dc.identifier.doi | 10.1016/s1474-4422(15)00104-0 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Faculty of Health/Peninsula Medical School | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine | |
plymouth.organisational-group | /Plymouth/Research Groups | |
plymouth.organisational-group | /Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED) | |
plymouth.organisational-group | /Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CBR | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
plymouth.organisational-group | /Plymouth/Users by role/Researchers in ResearchFish submission | |
dc.publisher.place | England | |
dcterms.dateAccepted | 2015-05-22 | |
dc.identifier.eissn | 1474-4465 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1016/s1474-4422(15)00104-0 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2015-07 | |
rioxxterms.type | Journal Article/Review |