Escala clínica predictora del riesgo de fallo ventilatorio en pacientes con esclerosis lateral amiotrófica.
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| Title: | Escala clínica predictora del riesgo de fallo ventilatorio en pacientes con esclerosis lateral amiotrófica. |
|---|---|
| Alternate Title: | Clinical scale of ventilatory failure risk in patients with amyotrophic lateral sclerosis. |
| Authors: | Fernandez, Romina1,2 (AUTHOR) fernandez.rn@gmail.com, Sívori, Martín1,2 (AUTHOR) |
| Source: | Medicina (Buenos Aires). ene/feb2026, Vol. 86 Issue 1, p60-72. 13p. |
| Subjects: | HYPERCAPNIA, PROGNOSTIC models, ARTIFICIAL respiration, DISEASE risk factors, RESPIRATORY insufficiency, SURVIVAL rate, RESPIRATORY muscles, AMYOTROPHIC lateral sclerosis |
| Abstract (English): | Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that causes atrophy and paralysis of skeletal muscles, including respiratory muscles. The development of ventilatory failure determines the prognosis. The primary outcome was to determine which common clinical variables can be predictors of daytime hypercapnia and develop a risk model of ventilatory failure. Secondary outcome was to determinate the survival rate of high-risk patients with and without hypercapnia. Materials and methods: Retrospective study. Patients with ALS without mechanical ventilation were selected and followed from June 2015 to May 2024. They under went arterial blood carbon dioxide measurement and classified into two groups hypercapnic (pCO2 ≥45 mmHg) and normocapnic (pCO2 <45 mmHg). Different predictive models for hypercapnia were constructed. Results: An association between orthopnea (p=0.0001), dyspnea (p=0.02) and FVC <50% (p=0.04) was found. The predictive model constructed with the following variables orthopnea, dyspnea and ALSFRS-R score ≤21, presented a good performance on the detection hy percapnia risk. A score > 23 points had a sensitivity of 80.6% and a specificity of 72.8% for detecting patients at high risk of hypercapnia. Normocapnic patients at high risk who start mechanical ventilation before de veloping hypercapnia improve their survival rate by 6 months (p=0.17). Discussion: The risk score includes easily obtained clinical variables and is effective in detecting patients at risk for hypercapnia. Initiating mechanical ventilation in at-risk patients who have not yet developed hypercapnia has a clinically significant impact on survival. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Introducción: La esclerosis lateral amiotrófica (ELA) es una enfermedad neurodegenerativa progresiva que genera atrofia y parálisis de la musculatura esquelética, incluida la respiratoria. El desarrollo del fallo ventila torio determina el pronóstico. El objetivo primario fue determinar qué variables clínicas habituales pueden ser predictoras de hipercapnia diurna y elaborar un modelo de riesgo del fallo ventilatorio. El objetivo secundario fue determinar la sobrevida de los pacientes con alto riesgo con y sin hipercapnia. Materiales y métodos: Estudio retrospectivo. Se eli gieron pacientes con ELA sin ventilación mecánica se guidos desde junio de 2015 a mayo de 2024 a los que se les realizó dosaje de dióxido de carbono en sangre arterial. Se los clasificó en dos grupos hipercápnicos (pCO2 ≥45 mmHg) y normocápnicos (pCO2 <45 mmHg). Se construyeron modelos predictores de hipercapnia con diferentes variables. Resultados: Se encontró asociación entre hipercap nia y ortopnea (p=0.0001), disnea (p=0.02) y CVF <50% (p=0.04). El modelo predictor que incluyó las variables ortopnea, disnea y puntaje de la escala ALSFRS-R ≤21, presentó un buen desempeño para detectar riesgo de hipercapnia. Un valor >23 puntos, tiene una sensibilidad de 80.6% y una especificidad de 72.8% para detectar estos pacientes. Los pacientes normocápnicos con alto riesgo que inician ventilación mecánica precozmente, mejoran su sobrevida en 6 meses (p=0.17). Discusión: Esta escala de riesgo incluye variables clínicas de fácil obtención y tiene un buen desempeño para detectar pacientes en riesgo de hipercapnia. Iniciar la ventilación mecánica en pacientes en riesgo que aún no desarrollaron hipercapnia tiene un impacto clínica mente significativo en la sobrevida. [ABSTRACT FROM AUTHOR] |
| Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Header | DbId: lth DbLabel: MedicLatina An: 192796605 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Escala clínica predictora del riesgo de fallo ventilatorio en pacientes con esclerosis lateral amiotrófica. – Name: TitleAlt Label: Alternate Title Group: TiAlt Data: Clinical scale of ventilatory failure risk in patients with amyotrophic lateral sclerosis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Fernandez%2C+Romina%22">Fernandez, Romina</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<i> fernandez.rn@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Sívori%2C+Martín%22">Sívori, Martín</searchLink><relatesTo>1,2</relatesTo> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Medicina+%28Buenos+Aires%29%22">Medicina (Buenos Aires)</searchLink>. ene/feb2026, Vol. 86 Issue 1, p60-72. 13p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22HYPERCAPNIA%22">HYPERCAPNIA</searchLink><br /><searchLink fieldCode="DE" term="%22PROGNOSTIC+models%22">PROGNOSTIC models</searchLink><br /><searchLink fieldCode="DE" term="%22ARTIFICIAL+respiration%22">ARTIFICIAL respiration</searchLink><br /><searchLink fieldCode="DE" term="%22DISEASE+risk+factors%22">DISEASE risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22RESPIRATORY+insufficiency%22">RESPIRATORY insufficiency</searchLink><br /><searchLink fieldCode="DE" term="%22SURVIVAL+rate%22">SURVIVAL rate</searchLink><br /><searchLink fieldCode="DE" term="%22RESPIRATORY+muscles%22">RESPIRATORY muscles</searchLink><br /><searchLink fieldCode="DE" term="%22AMYOTROPHIC+lateral+sclerosis%22">AMYOTROPHIC lateral sclerosis</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that causes atrophy and paralysis of skeletal muscles, including respiratory muscles. The development of ventilatory failure determines the prognosis. The primary outcome was to determine which common clinical variables can be predictors of daytime hypercapnia and develop a risk model of ventilatory failure. Secondary outcome was to determinate the survival rate of high-risk patients with and without hypercapnia. Materials and methods: Retrospective study. Patients with ALS without mechanical ventilation were selected and followed from June 2015 to May 2024. They under went arterial blood carbon dioxide measurement and classified into two groups hypercapnic (pCO2 ≥45 mmHg) and normocapnic (pCO2 <45 mmHg). Different predictive models for hypercapnia were constructed. Results: An association between orthopnea (p=0.0001), dyspnea (p=0.02) and FVC <50% (p=0.04) was found. The predictive model constructed with the following variables orthopnea, dyspnea and ALSFRS-R score ≤21, presented a good performance on the detection hy percapnia risk. A score > 23 points had a sensitivity of 80.6% and a specificity of 72.8% for detecting patients at high risk of hypercapnia. Normocapnic patients at high risk who start mechanical ventilation before de veloping hypercapnia improve their survival rate by 6 months (p=0.17). Discussion: The risk score includes easily obtained clinical variables and is effective in detecting patients at risk for hypercapnia. Initiating mechanical ventilation in at-risk patients who have not yet developed hypercapnia has a clinically significant impact on survival. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Spanish) Group: Ab Data: Introducción: La esclerosis lateral amiotrófica (ELA) es una enfermedad neurodegenerativa progresiva que genera atrofia y parálisis de la musculatura esquelética, incluida la respiratoria. El desarrollo del fallo ventila torio determina el pronóstico. El objetivo primario fue determinar qué variables clínicas habituales pueden ser predictoras de hipercapnia diurna y elaborar un modelo de riesgo del fallo ventilatorio. El objetivo secundario fue determinar la sobrevida de los pacientes con alto riesgo con y sin hipercapnia. Materiales y métodos: Estudio retrospectivo. Se eli gieron pacientes con ELA sin ventilación mecánica se guidos desde junio de 2015 a mayo de 2024 a los que se les realizó dosaje de dióxido de carbono en sangre arterial. Se los clasificó en dos grupos hipercápnicos (pCO2 ≥45 mmHg) y normocápnicos (pCO2 <45 mmHg). Se construyeron modelos predictores de hipercapnia con diferentes variables. Resultados: Se encontró asociación entre hipercap nia y ortopnea (p=0.0001), disnea (p=0.02) y CVF <50% (p=0.04). El modelo predictor que incluyó las variables ortopnea, disnea y puntaje de la escala ALSFRS-R ≤21, presentó un buen desempeño para detectar riesgo de hipercapnia. Un valor >23 puntos, tiene una sensibilidad de 80.6% y una especificidad de 72.8% para detectar estos pacientes. Los pacientes normocápnicos con alto riesgo que inician ventilación mecánica precozmente, mejoran su sobrevida en 6 meses (p=0.17). Discusión: Esta escala de riesgo incluye variables clínicas de fácil obtención y tiene un buen desempeño para detectar pacientes en riesgo de hipercapnia. Iniciar la ventilación mecánica en pacientes en riesgo que aún no desarrollaron hipercapnia tiene un impacto clínica mente significativo en la sobrevida. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Languages: – Code: spa Text: Spanish PhysicalDescription: Pagination: PageCount: 13 StartPage: 60 Subjects: – SubjectFull: HYPERCAPNIA Type: general – SubjectFull: PROGNOSTIC models Type: general – SubjectFull: ARTIFICIAL respiration Type: general – SubjectFull: DISEASE risk factors Type: general – SubjectFull: RESPIRATORY insufficiency Type: general – SubjectFull: SURVIVAL rate Type: general – SubjectFull: RESPIRATORY muscles Type: general – SubjectFull: AMYOTROPHIC lateral sclerosis Type: general Titles: – TitleFull: Escala clínica predictora del riesgo de fallo ventilatorio en pacientes con esclerosis lateral amiotrófica. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Fernandez, Romina – PersonEntity: Name: NameFull: Sívori, Martín IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Text: ene/feb2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 00257680 Numbering: – Type: volume Value: 86 – Type: issue Value: 1 Titles: – TitleFull: Medicina (Buenos Aires) Type: main |
| ResultId | 1 |
