Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482 |
Resumo: | Introduction: Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients’ satisfaction.Material and Methods: Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn’s scales, Katz index and patients’ global satisfaction were analysed.Results: In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 – 89) and the total follow-up time was 96 (9 – 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn’s scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.Discussion: The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.Conclusion: Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life. |
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Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese CentreBombas Perfusoras de Baclofeno Intratecal no Tratamento da Espasticidade: Estudo de Coorte Retrospetivo num Centro PortuguêsBaclofen/administration & dosageBaclofen/therapeutic useInfusion PumpsImplantableMuscle Spasticity/drug therapyBaclofeno/administração e dosagemBaclofen/uso terapêuticoBombas de Infusão ImplantáveisEspasticidade Muscular/tratamentoIntroduction: Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients’ satisfaction.Material and Methods: Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn’s scales, Katz index and patients’ global satisfaction were analysed.Results: In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 – 89) and the total follow-up time was 96 (9 – 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn’s scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.Discussion: The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.Conclusion: Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life.Introdução: A espasticidade é um problema complexo em doentes com distúrbios neurológicos influenciando a sua qualidade de vida. As bombas perfusoras intratecais de baclofeno reduzem a espasticidade com doses baixas e efeitos laterais mínimos, mas não estão livres de complicações. Pretendemos avaliar a eficácia, segurança e satisfação dos doentes com bombas perfusoras intratecais de baclofeno.Material e Métodos: Estudo de coorte retrospetivo, incluindo todas as bombas perfusoras intratecais de baclofeno colocadas até dezembro de 2015. Foram avaliadas as características demográficas, diagnósticos, data de colocação ou retirada/substituição e complicações das bombas perfusoras intratecais de baclofeno. Analisaram-se as escalas Ashworth, Penn, Katz e satisfação dos doentes.Resultados: Durante 19 anos colocaram-se 251 bombas perfusoras intratecais de baclofeno em 155 doentes. A idade média foi 41,1 ± 15,8 anos. As patologias mais freqüentes foram: traumatismo (34%), paralisia cerebral (14%), esclerose múltipla (12%) e acidente vascular cerebral (12%). Oitenta e cinco doentes (55%) precisaram de uma segunda e onze (7%) de uma terceira bomba. A semi-vida da primeira bomba foi 72 (36 – 89) e o tempo total de seguimento 96 (9 – 132) meses. As causas de retirada/substituição foram: falha de bateria (57%), migração/kinking do cateter (24%), infeção (14%) e deslocamento/exteriorização da bomba (7%). A taxa de complicações foi 0,21 eventos/mês. Houve uma melhoria significativa nas escalas de Ashworth e Penn após colocação das bombas perfusoras intratecais de baclofeno (p < 0,001 para todos os diagnósticos) e os doentes ficaram satisfeitos com o tratamento.Discussão: A incidência de complicações situou-se dentro do intervalo reportado por outros estudos internacionais, apesar do longo tempo de seguimento. Número de eventos por mês, perda de seguimento, taxas de re-intervenção ou infecção e mortalidade foram semelhantes a outros estudos.Conclusão: As bombas perfusoras intratecais de baclofeno são seguras e eficazes no tratamento da espasticidade e oferecem um alto nível de satisfação quanto ao tratamento e qualidade de vida.Ordem dos Médicos2019-12-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/tiffimage/tiffimage/tiffimage/tiffapplication/pdfapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482oai:ojs.www.actamedicaportuguesa.com:article/10482Acta Médica Portuguesa; Vol. 32 No. 12 (2019): December; 754-759Acta Médica Portuguesa; Vol. 32 N.º 12 (2019): Dezembro; 754-7591646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/5809https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10124https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10125https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10126https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10127https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11007https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11209https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11523Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessReis, Pedro VideiraVieira, Catarina RochaMidões, Ana CristinaRebelo, VirginiaBarbosa, PaulaGomes, Armanda2022-12-20T11:05:59Zoai:ojs.www.actamedicaportuguesa.com:article/10482Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:53.605932Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre Bombas Perfusoras de Baclofeno Intratecal no Tratamento da Espasticidade: Estudo de Coorte Retrospetivo num Centro Português |
title |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre |
spellingShingle |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre Reis, Pedro Videira Baclofen/administration & dosage Baclofen/therapeutic use Infusion Pumps Implantable Muscle Spasticity/drug therapy Baclofeno/administração e dosagem Baclofen/uso terapêutico Bombas de Infusão Implantáveis Espasticidade Muscular/tratamento |
title_short |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre |
title_full |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre |
title_fullStr |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre |
title_full_unstemmed |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre |
title_sort |
Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre |
author |
Reis, Pedro Videira |
author_facet |
Reis, Pedro Videira Vieira, Catarina Rocha Midões, Ana Cristina Rebelo, Virginia Barbosa, Paula Gomes, Armanda |
author_role |
author |
author2 |
Vieira, Catarina Rocha Midões, Ana Cristina Rebelo, Virginia Barbosa, Paula Gomes, Armanda |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Reis, Pedro Videira Vieira, Catarina Rocha Midões, Ana Cristina Rebelo, Virginia Barbosa, Paula Gomes, Armanda |
dc.subject.por.fl_str_mv |
Baclofen/administration & dosage Baclofen/therapeutic use Infusion Pumps Implantable Muscle Spasticity/drug therapy Baclofeno/administração e dosagem Baclofen/uso terapêutico Bombas de Infusão Implantáveis Espasticidade Muscular/tratamento |
topic |
Baclofen/administration & dosage Baclofen/therapeutic use Infusion Pumps Implantable Muscle Spasticity/drug therapy Baclofeno/administração e dosagem Baclofen/uso terapêutico Bombas de Infusão Implantáveis Espasticidade Muscular/tratamento |
description |
Introduction: Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients’ satisfaction.Material and Methods: Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn’s scales, Katz index and patients’ global satisfaction were analysed.Results: In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 – 89) and the total follow-up time was 96 (9 – 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn’s scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.Discussion: The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.Conclusion: Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-12-02 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482 oai:ojs.www.actamedicaportuguesa.com:article/10482 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/10482 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/5809 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10124 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10125 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10126 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10127 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11007 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11209 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11523 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2019 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
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application/pdf image/tiff image/tiff image/tiff image/tiff application/pdf application/msword application/pdf |
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Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 32 No. 12 (2019): December; 754-759 Acta Médica Portuguesa; Vol. 32 N.º 12 (2019): Dezembro; 754-759 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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