| Summary: | 碩士 === 高雄醫學大學 === 公共衛生學研究所 === 100 === Background
Few studies in the world have assessed the cause of death of amyotrophic lateral sclerosis patients. We investigated the mortality and underlying causes of death in patients with amyotrophic lateral sclerosis in Taiwan, 2003-2008.
Methods
A population-based data from National Health Insurance in Taiwan between 2003 and 2008 was utilized. A total number of 751 individuals with a primary diagnosis of ALS were included and followed until 2008 on a national mortality database. Crude mortality rate (per 100 person-year) and standardized mortality ratios (SMRs) were calculated by underlying cause of death, sex and age-group (0-44, 45-64, 65+).
Results
Of the 751 ALS individuals, a total of 297 (39.55%) died during the follow-up period ; representing a 13-fold (95% CI at 10.6-15.6) age- and gender-standardized increase in general population in Taiwan. Male mortality rate 17.99% (person-year) was similar with female 16.84% (person-year). But female SMR 21.5 (95% CI at 15.3-29.4) was significant higher than male SMR 9.5 (95% CI at 7.4-12.0). Cause of death on ALS was higher than the general population in infectious and respiratory diseases (SMR=49.6, 95% CI at 35.9-66.8), Cardiovascular diseases (SMR=11.7, 95% CI at 7.2-17.8) and suicide (SMR=6.9, 95% CI at 1.9-17.6). Of the 297 ALS individuals who died during the follow-up period, 154 individuals died in a medical facility and 134 individuals died outside a medical facility.
Conclusions
ALS patients predominate died cause by infectious and respiratory diseases, Cardiovascular diseases and suicide in Taiwan, 2003-2008. Suicide prevention was urgency in the early phase of ALS diagnosis in Taiwan.
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