Multidisciplinary clinic contributes to the decreasing trend in the number of emergency hospitalizations for amyotrophic lateral sclerosis in Japan

Abstract

BackgroundMultidisciplinary care is recommended for amyotrophic lateral sclerosis (ALS). We opened the first multidisciplinary care “ALS clinic” in Japan in February 2017. This study aimed to clarify the impact of multidisciplinary care on the number and incidence rate of emergency hospitalizations, as well as the survival rate of patients with ALS. MethodsWe studied the medical charts of patients with ALS who visited our hospital between March 1, 2014, and February 29, 2020, in a retrospective study. All patients were divided into two groups: a General Neurology Clinic group (GNC) and an ALS Clinic group (AC), based on the duration of the first visit to our hospital. ResultsThe survey participants included 90 patients with ALS (32 in the GNC vs 58 in the AC). The mean follow-up duration was 276 ± 257 days in the GNC and 307 ± 267 days in the AC. The number of emergency hospitalizations was 11 in the GNC and nine in the AC. The number of patients with two or more emergency hospitalizations was decreased in the AC (3 in the GNC vs 0 in the AC), which was statistically significantly different (p = 0.04). The survival rate was significantly different between the two groups (p = 0.01). ConclusionsOur results suggest that intervention through ALS multidisciplinary care in the hospital setting effectively controls emergency hospitalizations and improves the survival rate in patients with ALS. Multidisciplinary care is recommended since various medical treatments are required as the condition progresses.