Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model
Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease, the management of which requires the continuous provision of multidisciplinary therapies. Owing to the novel coronavirus disease (COVID-19) pandemic, regular contact with ALS patients at our center was severely restricted an...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-09-01
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| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/9/2873 |
| _version_ | 1797554474685825024 |
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| author | Robert Steinbach Tino Prell Nayana Gaur Beatrice Stubendorff Annekathrin Roediger Benjamin Ilse Otto W. Witte Julian Grosskreutz |
| author_facet | Robert Steinbach Tino Prell Nayana Gaur Beatrice Stubendorff Annekathrin Roediger Benjamin Ilse Otto W. Witte Julian Grosskreutz |
| author_sort | Robert Steinbach |
| collection | DOAJ |
| description | Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease, the management of which requires the continuous provision of multidisciplinary therapies. Owing to the novel coronavirus disease (COVID-19) pandemic, regular contact with ALS patients at our center was severely restricted and patient care was at risk by delay of supportive therapies. We established a triage system based on the D50 disease progression model and were thus able to identify a prospective cohort with high disease aggressiveness (D50 < 30). Thirty-seven patients with highly aggressive disease were actively offered follow-up, either via telephone or on-site, depending on their disease-specific needs and abilities. We describe here the procedures, obstacles, and results of these prescient efforts during the restrictions caused by COVID-19 in the period between March and June 2020. In conclusion, four patients with highly aggressive disease were initiated with non-invasive ventilation and two received a gastrostomy. We could show that a comparable amount of advanced care was induced in a retrospective cohort within a similar time period one year prior to the COVID-19 outbreak. Our workflow to identify high-risk patients via D50 model metrics can be easily implemented and integrated within existing centers. It helped to maintain a high quality of advanced care planning for our ALS patients. |
| first_indexed | 2024-03-10T16:32:36Z |
| format | Article |
| id | doaj.art-3278ef81e1824429b90e08984c887537 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T16:32:36Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3278ef81e1824429b90e08984c8875372023-11-20T12:41:14ZengMDPI AGJournal of Clinical Medicine2077-03832020-09-0199287310.3390/jcm9092873Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 ModelRobert Steinbach0Tino Prell1Nayana Gaur2Beatrice Stubendorff3Annekathrin Roediger4Benjamin Ilse5Otto W. Witte6Julian Grosskreutz7Hans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyHans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyHans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyHans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyHans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyHans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyHans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyHans Berger Department of Neurology, Jena University Hospital, 07747 Jena, GermanyAmyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease, the management of which requires the continuous provision of multidisciplinary therapies. Owing to the novel coronavirus disease (COVID-19) pandemic, regular contact with ALS patients at our center was severely restricted and patient care was at risk by delay of supportive therapies. We established a triage system based on the D50 disease progression model and were thus able to identify a prospective cohort with high disease aggressiveness (D50 < 30). Thirty-seven patients with highly aggressive disease were actively offered follow-up, either via telephone or on-site, depending on their disease-specific needs and abilities. We describe here the procedures, obstacles, and results of these prescient efforts during the restrictions caused by COVID-19 in the period between March and June 2020. In conclusion, four patients with highly aggressive disease were initiated with non-invasive ventilation and two received a gastrostomy. We could show that a comparable amount of advanced care was induced in a retrospective cohort within a similar time period one year prior to the COVID-19 outbreak. Our workflow to identify high-risk patients via D50 model metrics can be easily implemented and integrated within existing centers. It helped to maintain a high quality of advanced care planning for our ALS patients.https://www.mdpi.com/2077-0383/9/9/2873amyotrophic lateral sclerosisdisease progressionD50COVID-19SARS-CoV-2triage |
| spellingShingle | Robert Steinbach Tino Prell Nayana Gaur Beatrice Stubendorff Annekathrin Roediger Benjamin Ilse Otto W. Witte Julian Grosskreutz Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model Journal of Clinical Medicine amyotrophic lateral sclerosis disease progression D50 COVID-19 SARS-CoV-2 triage |
| title | Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model |
| title_full | Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model |
| title_fullStr | Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model |
| title_full_unstemmed | Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model |
| title_short | Triage of Amyotrophic Lateral Sclerosis Patients during the COVID-19 Pandemic: An Application of the D50 Model |
| title_sort | triage of amyotrophic lateral sclerosis patients during the covid 19 pandemic an application of the d50 model |
| topic | amyotrophic lateral sclerosis disease progression D50 COVID-19 SARS-CoV-2 triage |
| url | https://www.mdpi.com/2077-0383/9/9/2873 |
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