Impact of demographic factors, comorbidities, and co‐medication on progression and survival in a large Chinese ALS cohort

IF 0.4 Q4 CLINICAL NEUROLOGY Neurology and Clinical Neuroscience Pub Date : 2024-03-25 DOI:10.1111/ncn3.12802
Nan Hu, Lei Zhang, D. Shen, Xun-zhe Yang, Mingsheng Liu, Liying Cui
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Abstract

To clarify the impact of specific risk/protective factors on the disease progression and survival in a large population of Chinese sporadic ALS (sALS) patients.We investigated a cohort of 937 sALS patients prospectively. Uni‐ and multivariate regression analysis were performed to analyze the influence of demographic factors, comorbidities and medication on the progression and survival of ALS.Our results showed younger age of onset (p < 0.05), long diagnostic delay (p < 0.001) and intake of riluzole (p < 0.001) were significantly related to low progression rate and long survival time. History of smoking (p < 0.05) and bulbar onset (p < 0.001) were risk factors for rapid progression and poor prognosis. Baseline ALSFRS‐R score (p < 0.001) and total MRC score (p < 0.05) were positively related to mean survival time of included patients. Neither comorbidities nor intake of antihypertensive drugs, antidiabetics, and statins as dependent variables showed considerable influence on ALS progression or survival.Our study revealed early onset and long diagnostic delay were indicators of slow progression and long survival. Smoking and bulbar onset were risk factors for shorter survival times and abstaining from smoking was beneficial to patients with ALS in improving median survival time. Long‐term intake of riluzole should be recommended for affordable patients.
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中国大量 ALS 患者的人口统计学因素、合并症和联合用药对病情发展和生存期的影响
我们对937例中国散发性肌萎缩性脊髓侧索硬化症(ALS)患者进行了前瞻性研究。结果显示,发病年龄小(p < 0.05)、诊断延迟时间长(p < 0.001)和服用利鲁唑(p < 0.001)与低进展率和长生存期显著相关。吸烟史(p < 0.05)和球部发病(p < 0.001)是病情进展快和预后差的危险因素。基线 ALSFRS-R 评分(p < 0.001)和 MRC 总评分(p < 0.05)与纳入患者的平均生存时间呈正相关。合并症、服用降压药、抗糖尿病药和他汀类药物作为因变量,均未对ALS的进展或存活率产生显著影响。吸烟和球部发病是缩短存活时间的危险因素,戒烟有利于 ALS 患者延长中位存活时间。应建议经济条件允许的患者长期服用利鲁唑。
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