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Open Access 17-04-2024 | Duchenne Muscular Dystrophy | Original Communication

Respiratory comorbidities and treatments in Duchenne muscular dystrophy: impact on life expectancy and causes of death

Authors: Lisa Wahlgren, Anna-Karin Kroksmark, Anders Lindblad, Mar Tulinius, Kalliopi Sofou

Abstract

Background

Duchenne muscular dystrophy (DMD) is a neuromuscular disorder with progressive decline of pulmonary function increasing the risk of early mortality. The aim of this study was to explore the respiratory-related comorbidities, and the effect of these comorbidities and treatments on life expectancy and causes of death.

Methods

All male patients living in Sweden with DMD, born and deceased 1970–2019, were included. Data regarding causes of death were collected from the Cause of Death Registry and cross-checked with the medical records along with diagnostics and relevant clinical features.

Results

Hundred and twenty nine patients were included with a median lifespan of 24.3 years. Acute respiratory failure accounted for 63.3% of respiratory-related causes of death. 70.1% suffered at least one pneumonia, with first episode at a median age of 17.8 years. Hypoventilation was found in 73.0% with onset at 18.1 years. 60.5% had their first pneumonia before established hypoventilation. Age at onset of hypoventilation showed a strong correlation with age at first pneumonia. First pneumonia and scoliosis non-treated with scoliosis surgery increased the risk of dying of respiratory-related causes. In 10% of the patients, first pneumonia resulted in acute tracheostomy or early death. Patients treated with assisted ventilation had higher life expectancy compared to untreated patients.

Conclusions

Our results highlight the importance of identifying subclinical hypoventilation in a timely manner and the importance of an active treatment regime upon clinical signs of pneumonia.

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Title: Respiratory comorbidities and treatments in Duchenne muscular dystrophy: impact on life expectancy and causes of death
Authors: Lisa Wahlgren
Anna-Karin Kroksmark
Anders Lindblad
Mar Tulinius
Kalliopi Sofou
Publication date: 17-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Duchenne Muscular Dystrophy
Scoliosis
Pneumonia
Tracheostomy
Published in: Journal of Neurology
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-024-12372-7

At a glance: The STEP trials

Springer Medicine

Respiratory comorbidities and treatments in Duchenne muscular dystrophy: impact on life expectancy and causes of death

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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