Retrospective longitudinal study of ALS in Cyprus: Clinical characteristics, management and survival

Abstract

Introduction Amyotrophic lateral sclerosis (ALS) is a rare, progressive neurodegenerative disease. There is heterogeneity of clinical phenotypes while a clinical characterization of ALS in Cyprus is still lacking. The aim of this 30-year retrospective study of ALS in Cyprus is to determine the demographic characteristics of patients, the clinical features of the disease, the uptake of supportive therapies and factors influencing survival. Methods All ALS patients seen at the Cyprus Institute of Neurology and Genetics from January 1985 until July 2015 were included. Medical records of eligible patients were used for data extraction and compilation of an ALS database. Clinical features were compared between gender categories using univariate tests, while survival was assessed using Kaplan-Meier curves. Cox proportional hazards models were used to identify prognostic factors for survival. Results One hundred and seventy-nine ALS patients were included in the study, of whom 7 had a positive family history. Most clinical characteristics of ALS did not differ from what is observed in other European countries. However, some clinical characteristics were unique to our population, such as an increased acceptability and utilisation of supportive treatments such as gastrostomy. Conclusions Overall, clinical characteristics of patients with ALS in the Republic of Cyprus do not differ from other European counties. Our study demonstrates a high acceptance and utilisation of supportive interventions enhancing survival, in the context of a multidisciplinary approach offered in the single tertiary centre that services the whole Cypriot ALS population. The findings of this paper are of value to the health professionals treating ALS in Cyprus.

Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model

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A Differential Effect of Research Teaching Innovation on Dissertation Completion Rate and Pass Mark at TGSL

“…Based on the above context and philosophical stance, the paper applied a longitudinal research design whereby prior data on students' proposal and dissertation completion rates and pass marks were collected for the same group of individuals over time and compared with another longitudinal set of data. This design is apposite given that longitudinal approach permits repeated observation of the same variables and/or people over a short or long period; it also allows for retrospective investigation of the phenomenon using existing data (Demetriou et al, 2019;Weng et al, 2021). Drawing from the specified positivist paradigm above, the research applied a quantitative research method.…”

What do we know about the variability in survival of patients with amyotrophic lateral sclerosis?

“…In Serbia, 24% survived for 5 years and 17% for 7 years [67]. In Cyprus, approximately 20% of subjects lived for 5 years [68]. Table 2 summarizes some of these studies.…”

“…Attendance at a multi-disciplinary clinic leads to longer survival [110], possibly due to increased availability of interventions. Similarly, the increased use of modern therapies could explain why modern cohorts of patients, with access to these therapies, have longer survival than older cohorts [68,111,112].…”