Research on direct economic burden and its impact factors in hospitalized patients with amyotrophic lateral sclerosis underwent percutaneous endoscopic gastrostomy_West China Medical Journal

Authors：

LIANG Yan , LIU Yourong , HUANG Jing , GAO Mingyue , HU Linxue ,  CHEN Dezhi

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

CHEN Dezhi, Email: 737238683@qq.com

Keywords：

Amyotrophic lateral sclerosis; percutaneous endoscopic gastrostomy; economic burden

DOI：

10.7507/1002-0179.202410312

Video：

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Objectives To investigate the economic burden of percutaneous endoscopic gastrostomy (PEG) in hospitalized patients with amyotrophic lateral sclerosis (ALS) and analyze its influencing factors. Methods Clinical data of ALS patients who underwent PEG between 2014 and 2024 were collected through the inpatient electronic medical record system of West China Hospital of Sichuan University (including age, gender, comorbidities, disease course, daily living abilities, length of hospital stay, hospitalization costs, etc.), and their impact on the total hospitalization expenses were studied. Results A total of 102 patients were included. The median total hospitalization cost for ALS patients undergoing PEG was 12 701.00 (10 412.75, 16 720.00) yuan. The results of multiple linear regression analysis showed that the length of hospital stay and age of patients could affect the total hospitalization cost. Conclusions The total medical expenses for ALS patients undergoing PEG are approximately 10 000 yuan. Early assessment of the disease status in ALS patients, providing individualized management, and optimizing treatment plans to reduce hospital stay and medication costs can effectively control medical expenses.

Citation： LIANG Yan, LIU Yourong, HUANG Jing, GAO Mingyue, HU Linxue, CHEN Dezhi. Research on direct economic burden and its impact factors in hospitalized patients with amyotrophic lateral sclerosis underwent percutaneous endoscopic gastrostomy. West China Medical Journal, 2025, 40(1): 17-22. doi: 10.7507/1002-0179.202410312 Copy

1.	中華醫學會神經病學分會肌萎縮側索硬化協作組. 肌萎縮側索硬化診斷和治療中國專家共識 2022. 中華神經科雜志, 2022, 55(6): 581-588.
2.	Katzberg HD, Benatar M. Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev, 2011, 101(1): CD004030.
3.	Yang R, Huang R, Chen D, et al. Causes and places of death of patients with amyotrophic lateral sclerosis in south-west China. Amyotroph Lateral Scler, 2011, 12(3): 206-209.
4.	Miller RG, Rosenberg JA, Gelinas DF, et al. Practice parameter: the care of the patient with amyotrophic lateral sclerosis (an evidence-based review). Muscle Nerve, 1999, 22(8): 1104-1118.
5.	Stambler N, Charatan M, Cedarbaum JM. Prognostic indicators of survival in ALS. ALS CNTF Treatment Study Group. Neurology 1998, 50(1): 66-72.
6.	Burgos R, Bretón I, Cereda E, et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr, 2018, 37(1): 354-396.
7.	Shimizu T, Nakayama Y, Matsuda C, et al. Prognostic significance of body weight variation after diagnosis in ALS: a single-centre prospective cohort study. J Neurol, 2019, 266(6): 1412-1420.
8.	中華醫學會神經病學分會肌電圖與臨床神經電生理學組. 中國肌萎縮側索硬化診斷和治療指南. 中華神經科雜志, 2012, 45(7): 531-533.
9.	Printza A, Boziki M, Triaridis S, et al. Tongue strength, dysphagia questionnaire, pharyngeal secretions and FEES findings in dysphagia management in amyotrophic lateral sclerosis. Auris Nasus Larynx, 2021, 48(4): 672-682.
10.	Wei Q, Chen X, Zheng Z, et al. Clinical features of amyotrophic lateral sclerosis in south-west China. Amyotroph Lateral Scler Frontotemporal Degener, 2015, 16(7/8): 512-519.
11.	張新宇, 王麗平, 張俊, 等. 肌萎縮側索硬化患者使用內鏡經皮胃造瘺的影響因素. 世界華人消化雜志, 2011(7): 749-753.
12.	Liu MS, Cui LY, Fan DS, et al. Age at onset of amyotrophic lateral sclerosis in China. Acta Neurol Scand, 2014, 129(3): 163-167.
13.	廉羚, 林偉源, 向賢宏, 等. CT 引導下和內鏡下經皮胃造瘺術對肌萎縮側索硬化患者的療效觀察. 天津醫藥, 2023, 51(7): 687-690.
14.	Mehta P, Raymond J, Punjani R, et al. Prevalence of amyotrophic lateral sclerosis in the United States using established and novel methodologies, 2017. Amyotroph Lateral Scler Frontotemporal Degener, 2023, 24(1/2): 108-116.
15.	Chiò A, Logroscino G, Traynor BJ, et al. Global epidemiology of amyotrophic lateral sclerosis: a systematic review of the published literature. Neuroepidemiology, 2013, 41(2): 118-130.
16.	Miller RG, Jackson CE, Kasarskis EJ, et al. Practice parameter update: the care of the patient with amyotrophic lateralsclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2009, 73(15): 1218-1226.
17.	王麗平, 張新宇, 樊東升, 等. 中國肌萎縮側索硬化患者睡眠相關情況調查. 中國全科醫學, 2014, 17(5): 539-541,545.
18.	Wei Q, Chen X, Zheng Z, et al. Frontal lobe function and behavioral changes in amyotrophic lateral sclerosis: a study from Southwest China. J Neurol, 2014, 261(12): 2393-2400.
19.	姜躍龍, Xinsheng Liu, Daniel KY Chan. 內鏡下經皮胃造瘺術的并發癥及防治進展. 臨床消化病雜志, 2013, 25(1): 58-61.
20.	Roveron G, Antonini M, Barbierato M, et al. Clinical practice guidelines for the nursing management of percutaneous endoscopic gastrostomy and jejunostomy (PEG/PEJ) in adult patients: an executive summary. J Wound Ostomy Continence Nurs, 2018, 45(4): 326-334.
21.	Horiuchi A, Nakayama Y, Kajiyama M, et al. Nasopharyngeal decolonization of methicillin-resistant staphylococcus aureus can reduce PEG peristomal wound infection. Am J Gastroenterol, 2006, 101(2): 274-277.
22.	Thomas S, Cantrill S, Waghorn DJ, et al. The role of screening and antibiotic prophylaxis in the prevention of percutaneous gastrostomy site infection caused by methicillin-resistant Staphylococcus aureus. Aliment Pharmacol Ther, 2007, 25(5): 593-597.
23.	Radhakrishnan NV, Shenoy AH, Cartmill I, et al. Addition of local antiseptic spray to parenteral antibiotic regimen reduces the incidence of stomal infection following percutaneous endoscopic gastrostomy: a randomized controlled trial. Eur J Gastroenterol Hepatol, 2006, 18(12): 1279-1284.
24.	梁燕, 李銀萍, 陳德智. 肌萎縮側索硬化患者行經皮內鏡下胃造瘺術術后并發癥的觀察及護理. 華西醫學, 2015, 30(9): 1736-1738.
25.	楊玉玲, 孫夢姣, 余紅梅, 等. 山西省某醫院冠心病病人住院費用分析. 護理研究, 2024, 38(4): 694-697.
26.	唐濤, 王賽, 張雨篷, 等. 湖南省腦出血患者住院費用分析. 中國衛生統計, 2023, 40(1): 99-102.

1. 中華醫學會神經病學分會肌萎縮側索硬化協作組. 肌萎縮側索硬化診斷和治療中國專家共識 2022. 中華神經科雜志, 2022, 55(6): 581-588.
2. Katzberg HD, Benatar M. Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev, 2011, 101(1): CD004030.
3. Yang R, Huang R, Chen D, et al. Causes and places of death of patients with amyotrophic lateral sclerosis in south-west China. Amyotroph Lateral Scler, 2011, 12(3): 206-209.
4. Miller RG, Rosenberg JA, Gelinas DF, et al. Practice parameter: the care of the patient with amyotrophic lateral sclerosis (an evidence-based review). Muscle Nerve, 1999, 22(8): 1104-1118.
5. Stambler N, Charatan M, Cedarbaum JM. Prognostic indicators of survival in ALS. ALS CNTF Treatment Study Group. Neurology 1998, 50(1): 66-72.
6. Burgos R, Bretón I, Cereda E, et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr, 2018, 37(1): 354-396.
7. Shimizu T, Nakayama Y, Matsuda C, et al. Prognostic significance of body weight variation after diagnosis in ALS: a single-centre prospective cohort study. J Neurol, 2019, 266(6): 1412-1420.
8. 中華醫學會神經病學分會肌電圖與臨床神經電生理學組. 中國肌萎縮側索硬化診斷和治療指南. 中華神經科雜志, 2012, 45(7): 531-533.
9. Printza A, Boziki M, Triaridis S, et al. Tongue strength, dysphagia questionnaire, pharyngeal secretions and FEES findings in dysphagia management in amyotrophic lateral sclerosis. Auris Nasus Larynx, 2021, 48(4): 672-682.
10. Wei Q, Chen X, Zheng Z, et al. Clinical features of amyotrophic lateral sclerosis in south-west China. Amyotroph Lateral Scler Frontotemporal Degener, 2015, 16(7/8): 512-519.
11. 張新宇, 王麗平, 張俊, 等. 肌萎縮側索硬化患者使用內鏡經皮胃造瘺的影響因素. 世界華人消化雜志, 2011(7): 749-753.
12. Liu MS, Cui LY, Fan DS, et al. Age at onset of amyotrophic lateral sclerosis in China. Acta Neurol Scand, 2014, 129(3): 163-167.
13. 廉羚, 林偉源, 向賢宏, 等. CT 引導下和內鏡下經皮胃造瘺術對肌萎縮側索硬化患者的療效觀察. 天津醫藥, 2023, 51(7): 687-690.
14. Mehta P, Raymond J, Punjani R, et al. Prevalence of amyotrophic lateral sclerosis in the United States using established and novel methodologies, 2017. Amyotroph Lateral Scler Frontotemporal Degener, 2023, 24(1/2): 108-116.
15. Chiò A, Logroscino G, Traynor BJ, et al. Global epidemiology of amyotrophic lateral sclerosis: a systematic review of the published literature. Neuroepidemiology, 2013, 41(2): 118-130.
16. Miller RG, Jackson CE, Kasarskis EJ, et al. Practice parameter update: the care of the patient with amyotrophic lateralsclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2009, 73(15): 1218-1226.
17. 王麗平, 張新宇, 樊東升, 等. 中國肌萎縮側索硬化患者睡眠相關情況調查. 中國全科醫學, 2014, 17(5): 539-541,545.
18. Wei Q, Chen X, Zheng Z, et al. Frontal lobe function and behavioral changes in amyotrophic lateral sclerosis: a study from Southwest China. J Neurol, 2014, 261(12): 2393-2400.
19. 姜躍龍, Xinsheng Liu, Daniel KY Chan. 內鏡下經皮胃造瘺術的并發癥及防治進展. 臨床消化病雜志, 2013, 25(1): 58-61.
20. Roveron G, Antonini M, Barbierato M, et al. Clinical practice guidelines for the nursing management of percutaneous endoscopic gastrostomy and jejunostomy (PEG/PEJ) in adult patients: an executive summary. J Wound Ostomy Continence Nurs, 2018, 45(4): 326-334.
21. Horiuchi A, Nakayama Y, Kajiyama M, et al. Nasopharyngeal decolonization of methicillin-resistant staphylococcus aureus can reduce PEG peristomal wound infection. Am J Gastroenterol, 2006, 101(2): 274-277.
22. Thomas S, Cantrill S, Waghorn DJ, et al. The role of screening and antibiotic prophylaxis in the prevention of percutaneous gastrostomy site infection caused by methicillin-resistant Staphylococcus aureus. Aliment Pharmacol Ther, 2007, 25(5): 593-597.
23. Radhakrishnan NV, Shenoy AH, Cartmill I, et al. Addition of local antiseptic spray to parenteral antibiotic regimen reduces the incidence of stomal infection following percutaneous endoscopic gastrostomy: a randomized controlled trial. Eur J Gastroenterol Hepatol, 2006, 18(12): 1279-1284.
24. 梁燕, 李銀萍, 陳德智. 肌萎縮側索硬化患者行經皮內鏡下胃造瘺術術后并發癥的觀察及護理. 華西醫學, 2015, 30(9): 1736-1738.
25. 楊玉玲, 孫夢姣, 余紅梅, 等. 山西省某醫院冠心病病人住院費用分析. 護理研究, 2024, 38(4): 694-697.
26. 唐濤, 王賽, 張雨篷, 等. 湖南省腦出血患者住院費用分析. 中國衛生統計, 2023, 40(1): 99-102.

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Research on direct economic burden and its impact factors in hospitalized patients with amyotrophic lateral sclerosis underwent percutaneous endoscopic gastrostomy

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