A Predictive Model and Survival Analysis for Tube Feeding in ALS Patients: A Prospective Cohort Study in a Chinese ALS Clinic
Table 2
Factors associated with tube feeding in univariate and multivariate analysis with the Cox regression analysis ().
Variables
Univariate analysis
Multivariate analysis
cHR (95% CI)
value
aHR (95% CI)
value
Sex
0.72 (0.37-1.42)
0.34
Age of onset (y)
1.03 (1.00-1.06)
0.04
1.04 (1.00-1.08)
0.05
Bulbar onset
4.99 (2.49-9.99)
<0.001
0.68 (0.22-2.06)
0.49
Time to diagnose (m)
0.93 (0.89-0.98)
0.002
0.95 (0.90-1.01)
0.12
ALSFRS-R scorea
0.92 (0.90-0.94)
<0.001
ALSFRS-R slopea
6.36 (3.89-10.41)
<0.001
4.94 (2.26-10.81)
<0.001
NBRIa
2.65 (1.82-3.84)
<0.001
0.58 (0.12-2.79)
0.49
Bulbar involvementa
19.41 (4.64-81.28)
<0.001
11.87 (1.42-99.31)
0.02
Upper limb involvementa
1.56 (0.64-3.80)
0.32
Lower limb involvementa
3.22 (1.13-9.15)
0.03
1.89 (0.12-30.03)
0.65
Respiratory involvementa
4.53 (2.26-9.06)
<0.001
1.98 (0.31-12.53)
0.47
BMI a
0.86 (0.78-0.95)
0.003
1.09 (0.95-1.26)
0.23
Weight loss (kg)a
1.1 (1.05-1.14)
<0.001
1.05 (0.95-1.15)
0.34
Weight loss (%)a
2.55 (1.26-5.16)
0.01
0.85 (0.26-2.83)
0.79
Bulbar scorea
0.74 (0.69-0.80)
<0.001
0.81 (0.69-0.96)
0.01
Fine motor scorea
0.85 (0.78-0.93)
<0.001
1.05 (0.87-1.28)
0.59
Gross motor scorea
0.86 (0.79-0.95)
0.002
0.98 (0.81-1.20)
0.87
Respiratory scorea
0.81 (0.74-0.89)
<0.001
1.12 (0.89-1.40)
0.33
NIV routine usersb
4.91 (2.47-9.75)
<0.001
1.86 (0.59-5.87)
0.29
History of ischemic strokea
8.76 (2.65-28.97)
<0.001
5.69 (1.3-24.82)
0.02
Dyspneab
4.39 (1.98-9.75)
<0.001
1.00 (0.29-3.42)
0.99
Factors associated with tube feeding with value lower than 0.1 using the univariate Cox regression were enrolled in the multivariate Cox regression analysis. High ALSFRS-R slope, low bulbar score, history of ischemic stroke, and bulbar involvement were identified as independent risk factors of tube feeding using the multivariate Cox regression. Note: ALSFRS-R: Amyotrophic Lateral Sclerosis Functional Rating Scale revised; NBRI: body regions involved; BMI: body mass index; NIV: noninvasive ventilation; aHR: adjusted hazard ratio; cHR: crude hazard ratio; y: year; m: month; kg: kilogram; 95% CI: 95% confidence interval; a: at baseline; b: during follow-up; : number. In bold: value < 0.05.
