TY - JOUR
T1 - Frequency and outcomes of gastrostomy insertion in a longitudinal cohort study of atypical parkinsonism
AU - Kobylecki, Christopher
AU - Chelban, Viorica
AU - Goh, Yee Yen
AU - Michou, Emilia
AU - Fumi, Riona
AU - Theilmann Jensen, Marte
AU - Mohammad, Rahema
AU - Costantini, Alyssa
AU - Vijiaratnam, Nirosen
AU - Pavey, Samantha
AU - Pavese, Nicola
AU - Leigh, P Nigel
AU - Rowe, James B
AU - Hu, Michele T
AU - Church, Alistair
AU - Morris, Huw R
AU - Houlden, Henry
N1 - © 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2024/6/1
Y1 - 2024/6/1
N2 - BACKGROUND: Multiple 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.METHOD: We 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.RESULTS: In 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.CONCLUSIONS: Gastrostomy 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.
AB - BACKGROUND: Multiple 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.METHOD: We 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.RESULTS: In 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.CONCLUSIONS: Gastrostomy 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.
KW - Humans
KW - Gastrostomy
KW - Middle Aged
KW - Male
KW - Female
KW - Aged
KW - Longitudinal Studies
KW - Supranuclear Palsy, Progressive/surgery
KW - Multiple System Atrophy/surgery
KW - Parkinsonian Disorders/surgery
KW - Deglutition Disorders/etiology
KW - Cohort Studies
KW - Treatment Outcome
KW - Disease Progression
UR - http://www.scopus.com/inward/record.url?scp=85186602522&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/644e5b13-6f62-38c2-9d5d-46a2e2504f49/
U2 - 10.1111/ene.16258
DO - 10.1111/ene.16258
M3 - Article
C2 - 38407533
SN - 1351-5101
VL - 31
JO - EUROPEAN JOURNAL OF NEUROLOGY
JF - EUROPEAN JOURNAL OF NEUROLOGY
IS - 6
M1 - e16258
ER -