Trends in Invasive Interventions and Risk Factors for Early Critical Events in Multiple System Atrophy

Tarisawa, Monami; Matsushima, Masaaki; Kudo, Akihiko et al.

Cerebellum, 2025, 24(5), 152

Permalink : https://hdl.handle.net/2115/98068

このアイテムのアクセス数:34件（2026-10-17 12:41 集計）

閲覧可能ファイル 

ファイル フォーマット サイズ 閲覧回数 説明
huscap_manuscript_3clean pdf 574 KB 30

論文情報

ファイル出力 EndNote Basic出力 Mendeley出力

アクセス権
open access
URI
https://hdl.handle.net/2115/98068
タイトル
Trends in Invasive Interventions and Risk Factors for Early Critical Events in Multiple System Atrophy
著者
Tarisawa, Monami ; Matsushima, Masaaki ; Kudo, Akihiko ; Nomura, Taichi ; Uwatoko, Hisashi ; Shirai, Shinichi ; Takahashi-Iwata, Ikuko ; Sakushima, Ken ; Yaguchi, Hiroaki ; Yokota, Isao ; Nishimoto, Naoki ; Sawada, Jun ; Matsuoka, Takeshi ; Uesugi, Haruo ; Minami, Naoya ; Sako, Kazuya ; Takei, Asako ; Hisahara, Shin ; Kanatani, Yasuhiro ; Tamakoshi, Akiko ; Sato, Norihiro ; Yabe, Ichiro
著者名
Tarisawa, Monami
e-Rad_Researcher
10443938
著者名
Matsushima, Masaaki
e-Rad_Researcher
61018628
著者名
Kudo, Akihiko
e-Rad_Researcher
70756551
著者名
Nomura, Taichi
著者名
Uwatoko, Hisashi
著者名
Shirai, Shinichi
著者名
Takahashi-Iwata, Ikuko
著者名
Sakushima, Ken
e-Rad_Researcher
00421975
著者名
Yaguchi, Hiroaki
e-Rad_Researcher
20761414
著者名
Yokota, Isao
著者名
Nishimoto, Naoki
著者名
Sawada, Jun
著者名
Matsuoka, Takeshi
著者名
Uesugi, Haruo
著者名
Minami, Naoya
著者名
Sako, Kazuya
著者名
Takei, Asako
著者名
Hisahara, Shin
著者名
Kanatani, Yasuhiro
e-Rad_Researcher
90236737
著者名
Tamakoshi, Akiko
e-Rad_Researcher
50360912
著者名
Sato, Norihiro
著者名
Yabe, Ichiro
言語
英語
キーワード
Multiple system atrophy
MSA
HoRC-MSA
Risk factors
Care level
mRS
発行日
2025-09-06
出版者
Springer
収録物名
Cerebellum
巻(号)
24(5)
ページ
152
抄録
Multiple system atrophy (MSA) is a progressive, adult-onset neurodegenerative disorder involving autonomic failure, cerebellar ataxia, and parkinsonism. Patients often require invasive interventions, such as gastrostomy or tracheostomy, and sudden death is common. This study aimed to elucidate patterns of invasive treatment and identify risk factors for tracheostomy or sudden death within 5 years of onset. In total, 214 patients diagnosed with MSA between November 2014 and October 2024 across 66 institutions in Hokkaido were enrolled in the Hokkaido Rare Disease Consortium for MSA (HoRC-MSA). Patients were grouped by clinical course and interventions. We analyzed use of invasive procedures, including enteral nutrition via gastrostomy, enterostomy, esophagostomy, nasogastric tube insertion, central venous nutrition, tracheostomy, and ventilator support. Multivariable analyses were performed to compare patients with and without early critical events, defined as tracheostomy or sudden death within 5 years of disease onset. Invasive procedures were performed in 63.1% of patients. Patients receiving enteral nutrition and tracheostomy had prolonged survival. Early events correlated with older onset age (mean, 65.9 years), orthostatic hypotension, stridor, and an elevated apnea-hypopnea index (median, 32.45). Patients with preserved activities of daily living (ADL) in the Unified MSA Rating Scale part IV also had an increased risk of early critical events. Autonomic dysfunction, sleep-disordered breathing, and vocal cord impairment predict key risk factors for early mortality in patients with MSA. Monitoring is necessary, regardless of preserved ADL. The impact of invasive interventions on quality of life should be further explored.
資源タイプ
学術雑誌論文
出版タイプ
Accepted Manuscript
権利情報
This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s12311-025-01905-z
PISSN
1473-4222
関連情報 (isVersionOf)
出版社版DOI
https://doi.org/10.1007/s12311-025-01905-z