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Dissertation/Thesis Abstract

Feeding Tube Placement in Amyotrophic Lateral Sclerosis: Critically Assessing Outcomes, Indications, and Patient Preferences
by Greenwood, Daniel I., Ph.D., University of South Dakota, 2020, 134; 28257386
Abstract (Summary)

Amyotrophic lateral sclerosis (ALS) is a progressive and terminal neuromuscular disease. This research proposed three aims. The first aim was to determine if there is evidence that a feeding tube increases survival or improves quality of life for individuals with ALS. A systematic review of 9 survival articles and 6 quality of life articles determined that a meta-analysis of available studies is needed. There were 4 studies that demonstrated a survival benefit, and 5 studies, accounting for 53% of the composite study population, which found no survival advantage of feeding tube placement. Furthermore, there were three studies which found an improvement or reduction in decline in quality of life as a result of a feeding tube. Three additional studies found a decline in quality of life after feeding tube placement.

The second aim was to determine if there are relationships between respiratory function, weight, body mass index, physical function, dysphagia, dysarthria, age, form of disease onset and survival after feeding tube placement for the patient with ALS. There were four factors significantly associated with shorter survival after feeding tube placement: greater rates of body mass index, weight, Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised score decline, and older age. Longer survival after feeding tube placement was associated with bulbar onset, when compared to patients with limb onset.

The third aim was to determine if there was a main effect of feeding tube preference on a linear combination of overall quality of life, and composite domain scores of negative emotion, and interaction with people and environment. No statistically significant main effect was found.

Subsets of patients with ALS, which need further definition, benefit from a feeding tube.

Indexing (document details)
Advisor: Berg-Poppe, Patti
Commitee: Ikiugu, Moses, Hanson, Elizabeth, Nissen, Ranelle
School: University of South Dakota
Department: Health Sciences
School Location: United States -- South Dakota
Source: DAI-B 82/7(E), Dissertation Abstracts International
Subjects: Nutrition, Health sciences
Keywords: Amyotrophic lateral sclerosis, Feeding tube, Gastrostomy
Publication Number: 28257386
ISBN: 9798557089876
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