Specialized multidisciplinary care improves ALS survival in Belgium: a population-based retrospective study
Frederik Hobin, Joke De Vocht, Nikita Lamaire, Hilde Beyens, Fouke Ombelet, Philip Van Damme
Abstract
ALS is a neurodegenerative disease characterized by loss of motor neurons, resulting in progressive weakness and wasting of muscles. The average survival time is 2-5 years, mostly due to respiratory failure. Since current therapies can prolong survival time by only a few months, multidisciplinary care remains the cornerstone of the management of ALS. At the ALS Expert Centre of University Hospitals Leuven, a large proportion of Belgian ALS patients are seen for diagnosis and a significant number is also in follow-up with the multidisciplinary team. In this retrospective study, we compared the outcome of incident patients who were in follow-up at our site with patients who were not in follow-up. We included 659 patients of which 557 (84.5%) received specialized care at the ALS Expert Centre. After adjusting for clinically relevant prognostic parameters, multidisciplinary follow-up significantly prolonged survival (p 0.004; HR 0.683; CI 95% [0.528 -0.884]). This increase in survival is mainly driven by patients with spinal onset (p 0.035; HR 0.746; CI 95% [0.568 -0.980]), since no significant increased survival time was observed in patients with bulbar onset (p 0.28; HR 0.778; CI 95% [0.495 -1.223]). These data confirm that multidisciplinary follow-up contributes to a better outcome of patients, emphasizing the importance of multidisciplinary specialized care in ALS.