Racial Disparities in Intervention Rates in Individuals with ALS

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 .

Grantor dc:publisher

Wake Forest University

Year dc:date.issued

2018

Author dc:creator

• Qadri, Saman

• ALS

Language dc:language.iso

en

Handle dc:identifier.uri

http://hdl.handle.net/10339/90766

OAI identifier oai:identifier

oai:wakespace.lib.wfu.edu:10339/90766