[Advance of disability and prognosis in Duchenne muscular dystrophy--a comparison between institutionalized care and home care].

Rate of advance of disability and age at death were studied in patients with Duchenne muscular dystrophy (DMD). A comparison was made between DMD patients under care in their own homes and those hospitalized in National Suzuka Hospital. In 45 patients with home care, rate of advance of disability was considerably high in their age of 6 to 12 years, the average being 0.83 stage per year after the N.Y. University-Ueda's rating stage of disability. In the age of 12 to 17 years, however, the disease progression was much slower, the average being 0.14 stage per year. Beyond 18 years old, the average stage of disability was constantly 7.7, meaning almost bedridden stage. On the contrary, in 56 patients with institutionalized care, the average rate of advance was lower, being 0.5 stage per year in the age of 7 to 15 years and 0.13 stage per year from 15 to 23 years of age. The result of statistical analysis indicated that the stage of disability was significantly higher in the patients under the home care than those with institutionalized care at the age of 12-16, 18 and 19 years. The age when the patients became unable to walk was 9.7 +/- 1.8 years (mean +/- SD) in those with home care and 10.9 +/- 2.3 years in those with institutionalized care. The difference was statistically significant (p less than 0.01). The age at death was 18.3 +/- 3.8 years in 19 DMD patients with home care and 20.4 +/- 3.6 years in 33 patients with institutionalized care. The difference was also statistically significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)