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. Author manuscript; available in PMC: 2012 Dec 5.
Published in final edited form as: Amyotroph Lateral Scler. 2009 Oct-Dec;10(5-6):310–323. doi: 10.3109/17482960802566824

Table I. Studies of prognosis in ALS: studies based on referral series.

Reference Cases# Prospective/retrospective Mean age at onset (years) Median survival from onset (months) % 5-year survival from onset Significant prognostic factors Comments Drop-out rate (%)
[94] 668 R 56 36§ 39 Age, bulbar (worse) Highly selected cohort (ALS Foundation) NS
[32] 768 R NS NS 12.8 (ALS) 28.8 (PMA) 4.3 (PBP) Type on onset; age; protein content of CSF (worse if >61 mg/dl); presence of hyperactive reflexes or Babinski response (worse). Geographical region not significant Questionnaire to 24 neurological institutes in Japan. Only deceased cases included
[95] 515 R 50.8 NA NA ALS worse than PMA. Older age, bulbar, left limbs (worse) Only deceased cases 0
[96] 155 R 48 >72§ 56 § Age, diffusion of symptoms at time of diagnosis PMA only 3
[97] 318 R 56.6 36 29 Bulbar (worse) Israel national neurological register NS
[98] 27 R 50.3 24 8 None FALS only 0
[9] 336 R 57 60 (48 for ALS) 35 Age Type of onset non-significant Highly selected population 0
[65] 194 P 59 36 32 Age, ALS score, ALS duration 3
[8] 708 R 57 (m), 60 (f) (ALS) 49 (m) 54 (f) (benign ALS) 38 28 Plateau in survival of younger patients 162 more cases excluded due to various reasons 1
[99] 138 P 57.8 (m) 60.7 (w) 43.2 (m) 38.4 (w) NA Age Only deceased patients from a series of 246 0
[60] 167 P 56 NA 48 Age, presence of bulbar symptoms at entry, presence of fasciculations. Prevalent cases better than incident cases (4.7 vs. 2.1 years). 5 ALS centers in U.S. 1
[53] 144 R 55 NA NA Effect of distressing psychological factors (COX: OR 2.24 [1.08–4.64]) Patients from 3 ALS centers across U.S. 0
[10] 831 R 55.7 35 37.5 Age, diagnostic delay, slope of Appel score 0
[11] 158 R 62.7 25.0–26.9 14.7 COX: upper limbs worse than lower Bulbar worse than spinal Age at onset NS
[34] 71 R 31.2 25 Gender (women worse), age Bulbar not significant NS
[5] 90 P 56.8 23 (17 from onset of study + 6 pre-study) NA None Placebo arm of IGF-I trial NS
[12] 307 R 60 16.8§ NA Age, bulbar, time from onset to diagnosis 11 additional patients were excluded because they were lost to follow-up FALS not significant 0 (3%)
[28] 62 P 57 38.4 NA COX: linear estimate of decline in foot dorsiflexion strength, FVC%, grip strength Patients included in two trials NS
[16] 245 P 53.1 (surviving) 59.6 (deceased) NA NA Age; bulbar onset; body weight; weight change from prestudy; FVC; pCO2; ALSFRS score; muscle strength megascore Placebo arm of CNTF trial. Comparison between surviving and deceased patients 0
[40] 105 R 57.1 32 FVC at study entry (<80% worse than FVC ≥80%); bulbar (worse) The analysis included only the 74 patients for whom FVC was available COX: age, bulbar onset, diagnostic delay (per month), FVC% 30
[39] 155 P 54.2 47 NA Bulbar onset and >55 years worse COX: age, bulbar, faster progression in the first year of observation 92 other patients were excluded because of missing data 0
[13] 841 R 56 43 NA Age, referral delay, El Escorial classification Several variables with missing data NA
[67] 985 R NA 39 NA Mean age of onset lower in long survivors (43 vs. 57) Analysis of long survivors (>120 months) from a tertiary center database 22
[14] 793 R 56 34.8 24 Diagnostic delay, age, bulbar onset, diagnosis ≥1990 better than before 1990 0
[41] 267 R 61.7 33.6 NA COX: symptom duration, ALSFRS-R, FVC at baseline ALS referral center in New York City 3
[15] 1398 671 R 62.5 61.7 26 26 NA NA COX: Age (≥65, >65), disease duration at diagnosis (<2, >2 years), plasma creatinine, atrophy diffusion, pyramidal signs, spasticity, fasciculation, muscle strength (MMT), cough, swallowing, sVC Several variables with missing data, replaced with statistical artifices Patients separated in 2 cohorts 0
[56] 81 P NA NA NA FTLD significantly worse in univariate analysis but not in multivariate. COX: age and bulbar onset significant FLTD was significantly associated with bulbar onset and older age at onset 0
[100] 123 R 63.3 27 23 Age, lower limb onset (better), area of residence (mountainous areas worse), and work (agricultural workers worse) 0
[29] 1034 R 54.1 41.4 28 COX: FVC < 75% at baseline; age at onset, bulbar onset, duration at diagnosis PEG and NIPPV not significant A series of three papers concerning the same large series of cases (see also ref. 55 and 91) 0
[61] 1034 R 54.1 41.4 28 Prolonged survival related to younger age, limb site of onset and longer diagnostic delay, lower baseline AALSS, lower AALSS- preslope and higher baseline FVC 0
[101] 1034 R 54.1 41.4 28 Prolonged survival in more recent patients (1984–1998 vs. 1999–2004) 0
[50] 479 R 58 42.8 20 Prolonged survival related to young age at onset (<40), spinal onset, FVC >80 at diagnosis, longer diagnostic delay, ALSFRS-R score-ratio < 1.185 ALSFRS-R score ratio was calculated as ALSFRS-R score at first visit – ALSFRS-R score at last visit/time between first and last visit in months 18.90%