Venous thromboembolism (VTE) is a well-established cause of significant morbidity and mortality in the adult population with risk that increases with higher age and prolonged immobilization. VTE in patients with motor neuron disease (MND), including ALS is a known complication, though the overall incidence and associated risk factors are less clear. We retrospectively analyzed the incidence of VTE in a cohort of patients with MND to further evaluate.
650 patient records were identified by having a diagnosis of ALS, PLS or other adult MND between 2017 and 2021. 109 patients were identified as having an unknown or incorrect diagnosis, or had not been evaluated in the institution’s ALS multidisciplinary clinic and were excluded from the study. The primary outcome measure was symptomatic VTE (pulmonary embolism, deep venous thrombosis or both), at or after onset of symptoms related to their MND diagnosis. Clinic progress notes, including medications and diagnostic portions of the patient records were screened to identify the presence of VTE.
The overall incidence of symptomatic VTE in MND, including ALS patients was 9.6% (52/541 patients). The number of patients who had single visits only and were not seen in follow-up was 10.8% (64/541 patients). Of the 52 patients who were identified as having VTE, 75% (39 patients) were diagnosed with solely DVT, 17% with DVT and PE, and 7% with solely PE (4 patients).
The incidence of VTE in MND in our patient cohort was notable. We plan to conduct further analysis, including the identification of patients deemed to be higher risk for development of VTE including ambulatory status, pulmonary status (i.e. concurrent ventilator or bipap use) and severity of disease. Identifying high-risk patients could lead to earlier detection, prevention and treatment of VTE in high-risk patients with MND and improve quality of life.