Troubles neurologiques

Multidisciplinary Care Improves Survival of Patients with Amyotrophic Lateral Sclerosis in the Unique Health System (SUS) in Brazil

Abstract

Mirian Conceicao Moura, Luiz Augusto Casulari and Maria Rita Carvalho Garbi Novaes

Objective: To determine the effectiveness of multi-professional palliative care in patients with amyotrophic lateral sclerosis in Brazilian public health system.

Methods: Historic-control study before and after the Reference Center, with records and mortality data of 302 patients treated with riluzole between 2005 and 2015, were retrospectively evaluated and survival curves were analyzed.

Results: There were 181 men (59.9%) and 121 women (40.1%) with a diagnostic delay time of 28.1 months for spinal-onset and 20.1 months for bulbar-onset (p=0.003) and a mean survival of 61.7 ± 5.4 months for spinal-onset and 38 ± 3.5 months for bulbar-onset (p=0.01). Electromyography did not confirm the diagnosis in 55.6% of the suspected spinal-onset cases and 36.1% of the bulbar-onset. From 2005 to 2011, mean survival was 33.6 ± 2.4 months, and after multidisciplinary care, 72.2 ± 7.2 months (log-rank: 0.0001).

Conclusion: Multidisciplinary care improves the survival of amyotrophic lateral sclerosis patients in the Unique Health System.