Article Abstract

Prognostic indicators of neuromuscular disorders for palliative care referral

Authors: Richard Shek-Kwan Chang, Yuen Kwun Wong


Background: Most of the neuromuscular disorders (NMDs) have poor prognosis and lead to various symptoms amendable to palliative care. However, the suitable time of referral is uncertain.
Methods: A retrospective study was conducted to describe the trajectories of NMDs. Early death within one year after NMD diagnosis was set as the outcome. Total of 86 adult NMD patients were recruited in a university hospital. Demographic variable including gender, age at diagnosis and early-onset symptoms including dyspnea, dysphagia, loss of mobility, constipation, mood and sleep disorders, and pain were correlated with the outcome. Prediction models for early death were tested.
Results: Age at NMD diagnosis, early-onsets dyspnea, dysphagia, constipation and impaired mobility were found to have statistically significant correlation with early death. A prediction model consisted of these four factors had area under receiver operating characteristic (ROC) curve of 0.919.
Conclusions: Elder age at NMD diagnosis, early-onset dyspnea, dysphagia, constipation and impaired mobility within the first year after NMD diagnosis may predict mortality within the first year after diagnosis. It may provide guidance to clinicians for early palliative care referral in this patient group.