Résumé :
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Aim : to determine frequency of PEG/NIV in ALS patients in Serbian and their influence on duration of ALS. Methods : A total of 254 (96 female and 158 males) ALS patients were initially diagnosed between 2003-2008 at the Institute of Neurology in Belgrade, Serbia. Sixty eight had a bulbar and 186 had a spinal onset of the disease. Among them a group of 41 (18 females and 23 males) patients, 21 with spinal and 20 with bulbar onset, was formed with placed PEG and used NIV, due to dysphagia and/or respiratory insufficiency (FVC below 65%, Pa CO2 >6.0 kPa). Results : One hundred thirty six (64.3%) patients died, from the group of 213 ALS patients during the period from 2003 till the end of 2008. In the same period of time, 21(51.2%) died in a group of 41 patients, with PEG and NIV. The mean duration of the disease was longer in a group of patients with PEG and NIV (4.2 ±0.5 years) which was statistically significant in comparison with the group of patients without PEG/NIV (3.0 ± 0.1 years),(p < 0.05). In group with PEG/NIV 10 patients had respiratory insufficiency requiring NIV during PEG placement. There were no complications in all (41) but one patient. The routine PEG placement in patient with respiratory insufficiency started after foundation of “National center for home mechanical ventilation” and Insurance system payment for NIV devices since 2008. Conclusion : Only small numbers of ALS patients in Serbia (16.1%) were with PEG/NIV. The result of this study shows that much has to be done to prolong the life of our ALS patients and improve their quality of life.
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