Decision-making for tracheostomy in amyotrophic lateral sclerosis (ALS): a retrospective study

• DOI: 10.1080/21678421.2017.1317812
• Publication Date: 2017-04-29T07:07:14Z
• Authors: Piero Ceriana; Sara Surbone; Daniele Segagni; Annia Schreiber; Annalisa Carlucci
• Keywords: Male; Amyotrophic Lateral Sclerosis; Clinical Decision-Making; Decision Making; Patient Preference; Comorbidity; Middle Aged; Risk Assessment; 3. Good health; 03 medical and health sciences; Tracheostomy; 0302 clinical medicine; Italy; Utilization Review; Prevalence; Humans; Female; Respiratory Insufficiency; Amyotrophic lateral sclerosis; decision-making; planned; tracheostomy; unplanned; Retrospective Studies

Background: ALS patients should discuss the issue of tracheostomy before onset terminal respiratory failure. While process shared decision-making is desirable, there are few data on practical application this real-life situation.Aim study: To determine how a actually carried out, we analysed episodes acute failure preceding tracheostomy.Methods: We studied charts group after tracheostomy. An interview focusing existence anticipated directives was out. Tracheostomies were classified as planned or unplanned according to presence decision plan.Results: A total 209 cared for during three-year period. Of these patients, 34 (16%) tracheotomised. In 38% cases, planned, 41% unplanned, and 21% remained undiagnosed.Conclusions: minority make voluntary procedure conducted. The advising care still presents limits that have been thus far poorly addressed. future, will need develop guidelines timing content shared-decision making process.