Introduction: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease, which affects the lower and upper alpha motor neurons. Skeletal, bulbar and/or respiratory muscles may be impaired. Respiratory muscle damage can lead to death by respiratory failure. Purpose: The purpose of this study was to examine the effect of cough assist (CA) and noninvasive mechanical ventilation (NIMV) use on survival of ALS patients compared to using only one of the devices. Methods: The data of 36 patients were obtained at the Clinical Institute of Clinical Neurophysiology at UKC Ljubljana. The patients were devided into three groups, depending on which device/devices they used. We collected data of the patients age, when the disease started, date of the first symptomes, the date they started using at least one of the devices and the date of the bad outcome (death or invasive mechanical ventilation). Using a statistical programme, we compared the survival from the start of the disease until the bad outcome between the gropus and the time they started using the first device until the bad outcome. We analized, if age and group were a risk factor for a bad outcome. Lastly we analized, if age and the time of using the devices were a risk factor for a bad outcome for every group separately. Results: Overall, there was no significant difference in survival between the groups. We did notice, that the patients in the CA group started using the device later than in the other two groups. In the group that used both devices, time of use was a risk factor for a bad outcome. Discussion and conclusion: The results show that there is no significant difference in overall survival, no matter the device used. The disadvantage of this study was a small sample and no control group. We also didn't include the use of riluzol and percutaneous endoscopic gastrostomy. In future studies, the sample should be bigger, the patients should be devided depending on the muscle impairment (bulbar, spinal), ALS type, riluzol use and percutaneous endoscopic gastrostomy use. Both survival times (from first symptoms and date of diagnosis) should also be included, as well as a control group.
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