Frequency and outcomes of gastrostomy insertion in a longitudinal cohort study of atypical parkinsonism
Frequency and outcomes of gastrostomy insertion in a longitudinal cohort study of atypical parkinsonism
复制标题
非典型帕金森病纵向队列研究中胃造口术插入的频率和结果
DOI：
10.1111/ene.16258
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发表时间：
2024
影响因子：
5.1
通讯作者：
Kobylecki C
中科院分区：
文献类型：
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作者：
Kobylecki C
背景多系统萎缩（MSA）、进行性核上性麻痹（PSP）和皮质基底动脉综合征（CBS）是吞咽困难的高发病，且进展迅速，与生存率降低有关。尽管如此，胃造口术的证据基础很差，这种干预的最佳频率和结果尚不清楚。我们的目的是在这三种非典型帕金森病disorders.MethodWe分析的自然史和纵向队列的前景‐M‐UK研究长达60个月的随访基线的数据，在患者胃造口术的患病率和结果。使用Kaplan-Meier生存曲线分析胃造口术后的生存率。ResultsIn a total of 339 patients（平均年龄在症状发作时63.3岁，平均症状持续时间在基线时4.6年），吞咽困难是目前在所有疾病组在基线时>50%，并在随访期间显示快速进展。在总研究人群中，44例（13%）记录为推荐胃造口术，21例（6.2%; MSA 7例，PSP 11例，CBS 3例）进行胃造口术。胃造口术后的中位生存期为24个月，而建议胃造口术但未进行的中位生存期为12个月（p= 0.008）。然而，这是不显着时，纠正年龄和持续时间的症状，在程序或recommendation.ConclusionsGastrostomy进行相对不频繁，尽管在这个队列中的吞咽困难的患病率很高。胃造口术后的生存期比以前报告的要长，但关于其他结局以及临床医生和患者观点的进一步数据将有助于指导在MSA，PSP和CBS中使用这种干预措施。
BackgroundMultiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) show a high prevalence and rapid progression of dysphagia, which is associated with reduced survival. Despite this, the evidence base for gastrostomy is poor, and the optimal frequency and outcomes of this intervention are not known. We aimed to characterise the prevalence and outcomes of gastrostomy in patients with these three atypical parkinsonian disorders.MethodWe analysed data from the natural history and longitudinal cohorts of the PROSPECT‐M‐UK study with up to 60 months of follow‐up from baseline. Survival post‐gastrostomy was analysed using Kaplan–Meier survival curves.ResultsIn a total of 339 patients (mean age at symptom onset 63.3 years, mean symptom duration at baseline 4.6 years), dysphagia was present in >50% across all disease groups at baseline and showed rapid progression during follow‐up. Gastrostomy was recorded as recommended in 44 (13%) and performed in 21 (6.2%; MSA 7, PSP 11, CBS 3) of the total study population. Median survival post‐gastrostomy was 24 months compared with 12 months where gastrostomy was recommended but not done (p= 0.008). However, this was not significant when correcting for age and duration of symptoms at the time of procedure or recommendation.ConclusionsGastrostomy was performed relatively infrequently in this cohort despite the high prevalence of dysphagia. Survival post‐gastrostomy was longer than previously reported, but further data on other outcomes and clinician and patient perspectives would help to guide use of this intervention in MSA, PSP and CBS.