Patterns of mortality in patients with motor neurone disease

Acta Neurol Scand. 2003 Jan;107(1):50-3. doi: 10.1034/j.1600-0404.2003.02048.x.

Abstract

Objective: Motor neurone disease (MND) is a rapidly fatal condition with survival of less than 4 years. Patients can deteriorate quickly in the preterminal stages resulting in inappropriate resuscitation or admission to intensive care units (ICU) or accident and emergency (A & E).

Material and methods: We looked at patterns of mortality with emphasis on the place of death. A retrospective study was performed of all patients attending an MND clinic, who had died within a 10-year period.

Results: Of 179 patients (63 female), 81 patients (45%) died at home, in a hospice or in a nursing home. Sixty-five patients (36%) died in hospital (11 in ICU or A & E). Nine of the latter were previously known to have MND and six admissions were probably avoidable. Most ward patients died of respiratory causes and were treated conservatively.

Conclusion: The proportion of patients dying in A & E or ICU was small but could have been reduced further. A number of those who died on the wards could probably have been managed conservatively at home. Older patients and those with bulbar disease had a poorer prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Female
  • Health Services Misuse / statistics & numerical data
  • Hospital Mortality
  • Humans
  • Male
  • Medical Futility
  • Middle Aged
  • Motor Neuron Disease / diagnosis
  • Motor Neuron Disease / mortality*
  • Retrospective Studies
  • State Medicine / statistics & numerical data
  • Survival Rate
  • United Kingdom / epidemiology
  • Utilization Review