Overnight Pulse Oximetry to Determine Prognostic Factors in Subjects With Amyotrophic Lateral Sclerosis.
BACKGROUND: The objective of the current study was to determine whether overnight pulse oximetry in patients with amyotrophic lateral sclerosis is prognostic of the onset of awake respiratory failure and hospital admissions. METHODS: This was an observational study in a cohort of subjects with amyot...
| Publicado en: | Respiratory Care Vol. 65; no. 8; pp. 1128 - 1135 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Aug2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145118946&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145118946 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Aug2020 vid: 65 iid: 8 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 145118946 145118946 145118946 10.4187/respcare.07154 145118946 ppf: 1128 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Overnight Pulse Oximetry to Determine Prognostic Factors in Subjects With Amyotrophic Lateral Sclerosis. aug: au: Bote, Silvia Martín Martinez, Natalia Pascual Amarilla, Cristina Esteban Font Ugalde, Pilar Gonzalez-Bermejo, Jesús Feu Collado, Nuria Jurado Gamez, Bernabe affil: UGC Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain sug: subj: Pulse Oximetry Amyotrophic Lateral Sclerosis Prognosis Respiratory Failure Risk Factors Risk Assessment Patient Admission Human Nonexperimental Studies Prospective Studies Oxygen Saturation Home Diagnostic Tests Descriptive Statistics Anoxemia Male Female Middle Age Aged Body Mass Index Spine Anatomy and Histology Hospitalization Survival Motor Neuron Diseases Neuromuscular Diseases Respiration, Artificial Retrospective Design Spain Record Review Descriptive Research Mann-Whitney U Test Chi Square Test Kaplan-Meier Estimator Log-Rank Test Confidence Intervals Data Analysis Software Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: The objective of the current study was to determine whether overnight pulse oximetry in patients with amyotrophic lateral sclerosis is prognostic of the onset of awake respiratory failure and hospital admissions. METHODS: This was an observational study in a cohort of subjects with amyotrophic lateral sclerosis. The study included subjects with a baseline SpO2 ≥ 94% on home overnight pulse oximetry testing. Patients age ≥ 80 y and those with comorbidities and with poor short-term prognosis or sleep apnea were excluded. The subjects were classified as nocturnal desaturators according to percentage of sleep time with SpO2 < 90% (T90) > 10%. RESULTS: A total of 76 subjects were included: 40 men (53%), mean ± SD age 60 ± 14.4 y, mean ± SD body mass index 25.7 ± 4.60 kg/m2, and spinal presentation in 63.2%. After overnight pulse oximetry, 20 subjects (26%) were classified as desaturators and 56 (74%) as non-desaturators. In the first year, the subjects with nocturnal desaturation had respiratory failure more often compared with the subjects without desaturation (35% vs 10.91%; P = .02) and had a higher risk of developing respiratory failure during the course of the study (hazard ratio 2.48; P = .030). The desaturator group also had a higher rate of ≥ 1 admission (40% vs 7.3%; P = .01) and a higher likelihood of respiratory-related hospitalization (hazard ratio 2.41; P = .02). Median survival was almost 1 year less if T90 > 10% was observed in the overnight pulse oximetry: 21 months versus 32 months survival if T90 was ≤ 10%. CONCLUSIONS: In subjects with amyotrophic lateral sclerosis, nocturnal desaturation conferred a higher risk of respiratory failure and poorer prognosis. Even in the absence of other clinical criteria, early pulse oximetry should be performed and the need for nocturnal ventilatory support assessed. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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