RESEARCH: Prognosis of multiple system atrophy--survival time with or without tracheostomy

[Guest guest]

Rinsho Shinkeigaku 1999 May;39(5):503-7

Prognosis of multiple system atrophy--survival time with or without

tracheostomy

Kurisaki H.

Department of Neurology, National Tokyo Hospital.

Prognosis of 21 patients with multiple system atrophy (MSA) who deceased or

received tracheostomy is described. The percentage of patients with MSA

among the cases of spinocerebellar degeneration was 40% in National Tokyo

Hospital. There were 12 women and 9 men, and the mean age at onset was 56

years. Seventy-four percent of MSA patients was olivopontocerebellar atrophy

(OPCA), 22% was striatonigral degeneration (SND). The mean age of 17

deceased patients (10 women, and 7 men) was 65.5 years. Ten patients did not

undergo tracheostomy and deceased, and 11 patients underwent tracheostomy,

among whom 4 patients are still alive. Mean duration of illness from onset

to death (without tracheostomy) or tracheostomy was 6.8 years. Cause of

death of patients who did not undergo tracheostomy was related to paresis of

the larynx or pharynx, for example, aspiration pneumonia due to dysphagia,

vocal cord paralysis and sudden death. Some of those who underwent

tracheostomy deceased for causes which were not directly related to MSA such

as cerebral hemorrhage or uremia, but others seem to be related to some

problems of respiratory center such as central chronic respiratory failure,

or sudden death (sometimes it happened after infection, but the obstruction

of the respiratory tract was not always present at autopsy).

[Guest guest]

Pam,

You seem to have been especially busy lately.

I hope you know how much I and I am sure the others appreciate the fine job

your doing. THANKS!

God Bless,

Judy & Jim Stark

RESEARCH: Prognosis of multiple system atrophy--survival time

with or without tracheostomy

> Rinsho Shinkeigaku 1999 May;39(5):503-7

>

> Prognosis of multiple system atrophy--survival time with or without

> tracheostomy

>

>

> Kurisaki H.

>

> Department of Neurology, National Tokyo Hospital.

>

> Prognosis of 21 patients with multiple system atrophy (MSA) who deceased

or

> received tracheostomy is described. The percentage of patients with MSA

> among the cases of spinocerebellar degeneration was 40% in National Tokyo

> Hospital. There were 12 women and 9 men, and the mean age at onset was 56

> years. Seventy-four percent of MSA patients was olivopontocerebellar

atrophy

> (OPCA), 22% was striatonigral degeneration (SND). The mean age of 17

> deceased patients (10 women, and 7 men) was 65.5 years. Ten patients did

not

> undergo tracheostomy and deceased, and 11 patients underwent tracheostomy,

> among whom 4 patients are still alive. Mean duration of illness from onset

> to death (without tracheostomy) or tracheostomy was 6.8 years. Cause of

> death of patients who did not undergo tracheostomy was related to paresis

of

> the larynx or pharynx, for example, aspiration pneumonia due to dysphagia,

> vocal cord paralysis and sudden death. Some of those who underwent

> tracheostomy deceased for causes which were not directly related to MSA

such

> as cerebral hemorrhage or uremia, but others seem to be related to some

> problems of respiratory center such as central chronic respiratory

failure,

> or sudden death (sometimes it happened after infection, but the

obstruction

> of the respiratory tract was not always present at autopsy).

>

>

> If you do not wish to belong to shydrager, you may

> unsubscribe by sending a blank email to

>

> shydrager-unsubscribe

>

>

>

>

>

[Guest guest]

Pam,

I may be wrong, but this study does not meet strict scientific protocol for

a research study.

1. They do not state the criteria that was used to determine who needed a

tracheostomy.

2. They have no control group. Just because a patient got a tracheostomy

does not make them a control group for all MSA patients.

3. The paper indicates these patients were in an hospital environment, only

a subgroup of MSA patients. These patients were possibly sicker than non

hospitalized patients.

4. What if one were to also consider other forms of therapy such as speech

and swallowing therapy. along with these patients, it would make more sense.

5. Their group had " 12 women and 9 men " , this is not in line with the

female to male general ratio for MSA. This is a small group to be basing

such findings on.

6. They state that some of the patients died from other causes other than

MSA. No one dies of MSA, they die from the complications of having a failing

autonomic nervous system.

I just hate to see studies like this which makes sweeping statements for all

who are suffering from a given malady. Probably someone was in a " publish or

parish situation " , and these types of studies are the result.

Thanks for letting me get this off my chest. I don't know why, but this

study triggered the reaction in me.

God Bless,

Judy & Jim Stark

RESEARCH: Prognosis of multiple system atrophy--survival time

with or without tracheostomy

> Rinsho Shinkeigaku 1999 May;39(5):503-7

>

> Prognosis of multiple system atrophy--survival time with or without

> tracheostomy

>

>

> Kurisaki H.

>

> Department of Neurology, National Tokyo Hospital.

>

> Prognosis of 21 patients with multiple system atrophy (MSA) who deceased

or

> received tracheostomy is described. The percentage of patients with MSA

> among the cases of spinocerebellar degeneration was 40% in National Tokyo

> Hospital. There were 12 women and 9 men, and the mean age at onset was 56

> years. Seventy-four percent of MSA patients was olivopontocerebellar

atrophy

> (OPCA), 22% was striatonigral degeneration (SND). The mean age of 17

> deceased patients (10 women, and 7 men) was 65.5 years. Ten patients did

not

> undergo tracheostomy and deceased, and 11 patients underwent tracheostomy,

> among whom 4 patients are still alive. Mean duration of illness from onset

> to death (without tracheostomy) or tracheostomy was 6.8 years. Cause of

> death of patients who did not undergo tracheostomy was related to paresis

of

> the larynx or pharynx, for example, aspiration pneumonia due to dysphagia,

> vocal cord paralysis and sudden death. Some of those who underwent

> tracheostomy deceased for causes which were not directly related to MSA

such

> as cerebral hemorrhage or uremia, but others seem to be related to some

> problems of respiratory center such as central chronic respiratory

failure,

> or sudden death (sometimes it happened after infection, but the

obstruction

> of the respiratory tract was not always present at autopsy).

>

>

> If you do not wish to belong to shydrager, you may

> unsubscribe by sending a blank email to

>

> shydrager-unsubscribe

>

>

>

>

>

[Guest guest]

Hi Jim,

You know, I don't think this was meant to be a research study where a

certain group specifically was slated to receive tracheostomy and the rest

weren't.

This, I believe, was simply a review of the case histories of MSA patients

observed at this particular hospital. It looks to me like when they

reviewed these cases they noted whether they had tracheostomy or not and if

there seemed to be any correlation to survival time. Does it make more

sense when you look at it this way?

Take care,

Pam

RESEARCH: Prognosis of multiple system atrophy--survival

time

> with or without tracheostomy

>

>

> > Rinsho Shinkeigaku 1999 May;39(5):503-7

> >

> > Prognosis of multiple system atrophy--survival time with or without

> > tracheostomy

> >

> >

> > Kurisaki H.

> >

> > Department of Neurology, National Tokyo Hospital.

> >

> > Prognosis of 21 patients with multiple system atrophy (MSA) who deceased

> or

> > received tracheostomy is described. The percentage of patients with MSA

> > among the cases of spinocerebellar degeneration was 40% in National

Tokyo

> > Hospital. There were 12 women and 9 men, and the mean age at onset was

56

> > years. Seventy-four percent of MSA patients was olivopontocerebellar

> atrophy

> > (OPCA), 22% was striatonigral degeneration (SND). The mean age of 17

> > deceased patients (10 women, and 7 men) was 65.5 years. Ten patients did

> not

> > undergo tracheostomy and deceased, and 11 patients underwent

tracheostomy,

> > among whom 4 patients are still alive. Mean duration of illness from

onset

> > to death (without tracheostomy) or tracheostomy was 6.8 years. Cause of

> > death of patients who did not undergo tracheostomy was related to

paresis

> of

> > the larynx or pharynx, for example, aspiration pneumonia due to

dysphagia,

> > vocal cord paralysis and sudden death. Some of those who underwent

> > tracheostomy deceased for causes which were not directly related to MSA

> such

> > as cerebral hemorrhage or uremia, but others seem to be related to some

> > problems of respiratory center such as central chronic respiratory

> failure,

> > or sudden death (sometimes it happened after infection, but the

> obstruction

> > of the respiratory tract was not always present at autopsy).