A Predictive Model and Survival Analysis for Tube Feeding in ALS Patients: A Prospective Cohort Study in a Chinese ALS Clinic
Table 3
The clinical characteristics of patients referred to tube feeding, stratified by the tube feeding at diagnosis or during follow-up.
Variables
Tube feeding acceptance
Total ()
Statistics
No ()
Yes ()
(%) or mean (SD) or median (IQR)
(%) or mean (SD) or median (IQR)
(%) or mean (SD) or median (IQR)
At baseline
Sex
1
Male
21 (56.8)
19 (55.9)
40 (56.3)
Female
16 (43.2)
15 (44.1)
31 (43.7)
Familiar ALS
5 (13.5)
3 (8.8)
8 (11.3)
Fisher’s exact test
0.712
Age of onset (y)
53.27 (11.81)
58.09 (12.37)
55.58 (12.24)
-test
0.098
Death
12 (32.4)
14 (41.2)
26 (36.6)
0.605
Site of disease onset
0.586
Bulbar
14 (37.8)
16 (47.1)
30 (42.3)
Spinal
23 (62.2)
18 (52.9)
41 (57.7)
Time to diagnose (m)
12.00 (9.00, 18.00)
9.00 (6.25, 12.00)
11.00 (8.00, 14.50)
Mann–Whitney test
0.016
With loss of body weight at baseline
25 (67.6)
22 (64.7)
47 (66.2)
0.997
BMI at baseline (kg/m2)
21.24 (3.14)
21.15 (4.08)
21.20 (3.59)
-test
0.911
Weight loss at baseline (kg)
3.00 (0.00, 5.00)
5.00 (0.00, 10.00)
5.00 (0.00, 10.00)
Mann–Whitney test
0.253
NBRI
Fisher’s exact test
0.159
1
6 (16.2)
2 (5.9)
8 (11.3)
2
8 (21.6)
5 (14.7)
13 (18.3)
3
12 (32.4)
9 (26.5)
21 (29.6)
4
10 (27.0)
18 (52.9)
28 (39.4)
The involvement of different segments
Bulbar involvement
30 (81.1)
32 (94.1)
62 (87.3)
Fisher’s exact test
0.155
Upper limb involvement
28 (75.7)
28 (82.4)
56 (78.9)
0.691
Lower limb involvement
25 (67.6)
30 (88.2)
55 (77.5)
0.072
Respiratory involvement
15 (40.5)
21 (61.8)
36 (50.7)
0.121
ALSFRS-R score
37.00 (31.00, 40.00]
31.00 (18.00, 36.75)
35.00 (27.50, 39.50)
Mann–Whitney test
0.005
Bulbar score
10.00 (6.00, 11.00)
5.50 (2.00, 10.00)
9.00 (5.00, 11.00)
Mann–Whitney test
0.003
Fine motor score
9.00 (6.00, 11.00)
7.00 (3.00, 9.00)
8.00 (4.00, 10.00)
Mann–Whitney test
0.034
Gross motor score
8.00 (6.00, 10.00)
5.00 (2.00, 8.75)
7.00 (3.00, 10.00)
Mann–Whitney test
0.094
Respiratory score
12.00 (11.00, 12.00)
11.00 (9.00, 12.00)
12.00 (10.00, 12.00)
Mann–Whitney test
0.026
ALSFRS-R slope
0.58 (0.35, 0.92)
0.84 (0.56, 1.37)
0.71 (0.45, 1.23)
Mann–Whitney test
0.038
Ischemic stroke
0 (0.0)
3 (8.8)
3 (4.2)
Fisher’s exact test
0.105
During follow-up
NIV routine users
12 (32.4)
20 (58.8)
32 (45.1)
0.046
Dyspnea
21 (56.8)
26 (76.5)
47 (66.2)
0.133
Dysphagia
30 (81.1)
24 (70.6)
54 (76.1)
0.449
Past history
Hyperlipidemia
1 (2.7)
4 (11.8)
5 (7.0)
Fisher’s exact test
0.187
Hypertension
10 (27.0)
11 (32.4)
21 (29.6)
0.817
Diabetes
2 (5.4)
1 (2.9)
3 (4.2)
Fisher’s exact test
1
Drinking
12 (32.4)
12 (35.3)
24 (33.8)
0.997
Smoking
15 (40.5)
13 (38.2)
28 (39.4)
1
Depression
1 (2.7)
0 (0.0)
1 (1.4)
Fisher’s exact test
1
Anxiety
0 (0.0)
1 (2.9)
1 (1.4)
Fisher’s exact test
0.479
Malignancy
3 (8.1)
1 (2.9)
4 (5.6)
Fisher’s exact test
0.615
Allergy
0 (0.0)
2 (5.9)
2 (2.8)
Fisher’s exact test
0.226
Exposure of toxic substances
5 (13.5)
6 (17.6)
11 (15.5)
0.879
Trauma
7 (18.9)
9 (26.5)
16 (22.5)
0.634
Surgical history
14 (37.8)
12 (36.4)
26 (37.1)
1
Tube feeding consists of gastrostomy and nasogastric tube feeding. Patients who received tube feeding had a shorter time from disease onset to diagnosis, lower ALSFRS-R score, lower bulbar score, lower fine motor score, and lower respiratory score than patients without swallowing intervention at baseline. During the follow-up, patients who received tube feeding were more likely to receive NIV support than those without. However, ALS patients with past history at diagnosis (such as hyperlipidemia, hypertension, diabetes, drinking, smoking, depression, anxiety, malignancy, allergy, exposure of toxic substances, trauma, and surgical history) had no difference in the acceptance of tube feeding. Familiar ALS patients were not more accepting of tube feeding than others. The mortality rate of patients with tube feeding was similar to those without tube feeding. Note: ALSFRS-R: Amyotrophic Lateral Sclerosis Functional Rating Scale revised; BMI: body mass index; y: year; m: month; kg: kilogram; NIV: noninvasive ventilation; NBRI: body regions involved; : number; : probability. In bold: value < 0.05.
