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ALSFRS-R Score Predicts Survival Time in Chinese ALS Patients

Author: ZhongLingLing
Tutor: ZhaoXueXu;XuJun
School: Nanjing Medical University
Course: Neurology
Keywords: Amyotrophic lateral sclerosis Amyotrophic lateral sclerosis functional rating scale revised ⊿FS survival time
CLC: R744
Type: Master's thesis
Year: 2011
Downloads: 48
Quote: 0
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Abstract


[Backgrounds]Amyotrophic lateral sclerosis, (ALS) is a group of unknown etiology, fatal degeneration of the nervous system, which affects motor neurons at 2 or more levels supplying multiple regions of the body. It affects lower motor neurons that reside in the anterior horn of the spinal cord and in the brain stem; corticospinal upper motor neurons with a progressive limbic or bulbar muscular weakness and wasting.It was first discovered in 1869 by Charcot and reported that average survival is only 3 to 5 years. Factors that affect the survival time of patients with certain sex, age, onset of symptoms, course of disease, FVC.Recently ALSFRS-R and⊿FS can predict disease progression.Amyotrophic lateral sclerosis functional rating scale revised (ALSFRS-R) formed by the 12, 1. Language, 2 Saliva secretion, 3. Swallowing, 4 .Writing, 5.Cutting food, using utensils, 6. Clothing and health care of themselves, 7.Turning in bed and adjusting bed clothes, 8.walking, 9.climbing stairs, 10.dyspnea, 11.orthopnea, 12.respiratory insufficiency. The Revised ALSFRS (ALSFRS-R) retains the properties of the original scale and shows strong internal consistency and construct validity.⊿FS“48 ? ALSFRS-R score at first visit / time between first symptom and first examination in months”.Foreign scholars with ALSFRS-R score (11 years) and the linear rate of change (⊿ FS) can predict survival time, but also can predict disease progression. To further verify the ALSFRS-R scores and⊿ FS associated with survival, we conducted a preliminary summary. [Objective] To study the Amyotrophic lateral sclerosis functional rating scale revised and its progression rate of ALSFRS-R correlation with survival time.[Methods]Application of 2000 word Union of Neurology El Escorial diagnostic criteria retrospectively analyzed 64 case of amyotrophic lateral sclerosis clinical date, be ALSFRS-R score and the progress rate(⊿FS)and Kaplan-Meier analysis was used from onset to tracheostomy or death ,the median group and Log-rank analysis was used to estimate the difference between two groups. Application of Cox proportional hazards model, adjust the parameters of multi-factor analysis: sex, age, onset duration, forced vital capacity, FVC.[Results] 64 ALS patient were followed, lost 8,56 incision of tracheal or death, M:F=2.7:1, the average survival time of 3.5 years. Log-rank analysis two groups p<0.05,statisticallysignificant.Application of Cox proportional hazards model ALSFRS-R(HR:0.87 95% CI 0.82-0.93 P〈0.01),⊿FS(HR:5.52 95% CI 3.13-9.71 P〈0.01).[Conclusions]ALSFRS-R and⊿FS predict the survival time of ALS patients.

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