Table 3 Impact of PEG on survival in patients with an indication for PEG (univariate and multivariate analysis with Cox proportional hazard model, n = 188).

Variables	Univariate				Multivariate
Variables	HR	95% CI		p	HR	95% CI		p
Bulbar onset	1.426	0.855	2.377	0.174	1.110	0.556	2.215	0.768
Time from symptom onset to diagnosis	0.972	0.941	1.004	0.084	1.012	0.962	1.065	0.646
Time from symptom onset to PEG placement	0.965	0.947	0.982	< 0.001	0.974	0.937	1.011	0.169
BMI at PEG	1.100	1.024	1.181	0.009	1.062	0.977	1.155	0.155
ALSFRS-R at diagnosis^a	0.997	0.953	1.042	0.880	1.014	0.932	1.103	0.741
Bulbar subscore^b	0.924	0.831	1.027	0.144	1.114	0.819	1.514	0.492
Swallowing score^c	0.724	0.516	1.016	0.062	0.759	0.379	1.519	0.436
ALSFRS-R at PEG^a	1.041	1.013	1.069	0.003	1.017	0.967	1.069	0.520
Bulbar score^b	1.052	0.938	1.179	0.385	0.969	0.774	1.214	0.786
Swallowing score^c	1.168	0.865	1.576	0.310	0.927	0.591	1.453	0.741
Rate of decline
From onset to diagnosis^d	1.426	1.176	1.730	< 0.001	1.523	1.148	2.020	0.004
From diagnosis to PEG^e	1.109	0.925	1.331	0.264	0.921	0.688	1.232	0.579
From T-_rec to PEG^f	1.026	0.964	1.092	0.413	0.989	0.899	1.088	0.819
Time from T_-rec to PEG	0.943	0.905	0.982	0.005	0.974	0.917	1.034	0.383
Incidence of aspiration pneumonia before PEG	1.733	0.693	4.335	0.240	3.513	1.206	10.229	0.021
Incidence of tracheostomy before PEG	0.582	0.250	1.353	0.209	0.503	0.182	1.388	0.185
Pharmacological treatment options received
Riluzole	1.022	0.553	1.888	0.945	1.683	0.817	3.467	0.158
Edaravone	1.165	0.616	2.204	0.638	0.827	0.396	1.727	0.612
Nuedexta	1.379	0.334	5.694	0.657	1.053	0.219	5.054	0.949

HR, hazard ratio; CI, confidence interval at 95%; p, probability; PEG: percutaneous endoscopic gastrostomy; BMI, body mass index; ALSFRS-R, amyotrophic lateral sclerosis functional rating scale revised; ΔFS, disease progression rate; T-rec for gastrostomy, recommended time for PEG insertion.
^aALSFRS-R total score ranges from 0 to 48 points; ^bbulbar subset for the sum of ALSFRS-R question 1–3 (speech, salivation, swallowing) ranges from 0 to 12 points; ^cScore for ALSFRS-R question 3 (swallowing) ranges from 0 to 4 points; ^d Rate of decline from onset to diagnosis was calculated using the following formula: Rate of decline = (48—ALSFRS-R score at the time of diagnosis)/duration from symptom onset to the time of diagnosis (months). ^eRate of decline from diagnosis to PEG was calculated using the following formula: Rate of decline = (ALSFRS-R score at the time of diagnosis—ALSFRS-R score at the time of PEG)/duration from diagnosis to the time of PEG (months). ^fRate of decline from T-rec for gastrostomy to PEG was calculated using the following formula: Rate of decline = (ALSFRS-R score at the T-rec for tastrostomy—ALSFRS-R score at the time of PEG)/duration from T-rec for gastrostomy to the time of the PEG (months).

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