2026-09-20T11:16:38Zhttps://wakespace.lib.wfu.edu/server/oai/requestoai:null:10339/907662026-09-02T09:28:52Zcom_10339_14934col_10339_38132
Qadri, Saman
2018-05-24T08:36:20Z
2019-05-23T08:30:10Z
2018
https://wakespace.lib.wfu.edu/handle/10339/90766
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative
motor neuron
disorder
that causes muscular atrophy
. Though researchers have established a correlation between
race and survival, it is still not well understood whether there are differences in severity at
time of diagnosis and subsequently, interventions
chosen by ALS patients.
The
goal
of this
study was to understand whether disease se
verity at time of diagnosis
and interventions
chosen by ALS patients were different when stratified by self
-
identified race.
A
retrospective chart review was conducted on 49
African American ALS patients and 137
Caucasian ALS patients.
70.10% of Caucasian patients used
noninvasive ventilation (
NIV
)
compared to 55.10% of African Americans (p
-
value= 0.015). However, 5.22% of
Caucasian patients used
tracheostomy with invasive ve
ntilation (
TIV
)
compared to 16.33%
of African American patients (p
-
value= 0.018). After accounting for baseline severity and
caregiver availability, the significance of differences in NIV (p
-
value= 0.057) and TIV (p
-
value=0.109) use decreased. After adjust
ing for baseline seve
rity and caregiver, PEG use
approached
significance (p
-
value 0.068).
After adjusting for SES, NIV differences are
statistically significant (p
-
value= 0.045) while PEG further borders significance (p
-
value=
0.055).
Therefore, s
elf
-
ident
ified race plays a
n important
role in
differences in rates of
NIV
and PEG
.
This research is the first of its kind to analyze social determinants of health and
intervention rates.
Future research should
utilize a larger sample size and
explore patients’
per
spectives on their ALS diagnosis and interventions
.
en
Wake Forest University
ALS
health disparities
NIV rates
Racial Disparities in Intervention Rates in Individuals with ALS
Thesis
Cartwright, Michael S
Milligan, Carolanne E.
Langefeld, Carl D.
Caress, James B.
Health Disparities in Neuroscience-related Disorders – MS
2019-05-23
open.access