Limits...
Mortality of patients with multiple sclerosis: a cohort study in UK primary care.

Jick SS, Li L, Falcone GJ, Vassilev ZP, Wallander MA - J. Neurol. (2014)

Bottom Line: MS patients (N = 1,822) had a significantly increased risk of all-cause mortality compared with referents (N = 18,211); adjusted HR 1.7 (95 % CI 1.4-2.1).A significantly higher proportion of referents than MS patients had cancer recorded as cause of death (40 vs. 19 %).Patients with MS have a significant 1.7-fold increased risk of all-cause mortality compared with the general population.

View Article: PubMed Central - PubMed

Affiliation: Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, 11 Muzzey Street, Lexington, MA, 02421, USA, sjick@bu.edu.

ABSTRACT
We aimed to estimate rates, causes and risk factors of all-cause mortality in a large population-based cohort of multiple sclerosis (MS) patients compared with patients without MS. Using data from the UK General Practice Research Database, we identified MS cases diagnosed during 2001-2006 and validated using patients' original records where possible. We also included MS cases during 1993-2000 identified and validated in an earlier study. Cases were matched to up to ten referents without MS by age, sex, index date (date of first MS diagnosis for cases and equivalent reference date for controls), general practice and length of medical history before first MS diagnosis. Patients were followed up to identify deaths; hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox-proportional regression. MS patients (N = 1,822) had a significantly increased risk of all-cause mortality compared with referents (N = 18,211); adjusted HR 1.7 (95 % CI 1.4-2.1). Compared with referents, female MS patients had a higher but not significantly different HR for death than males; adjusted HR 1.86 (95 % CI 1.46-2.38) vs. HR 1.31 (95 % CI 0.93-1.84), respectively. The most commonly recorded cause of death in MS patients was 'MS' (41 %), with a higher proportion recorded among younger patients. A significantly higher proportion of referents than MS patients had cancer recorded as cause of death (40 vs. 19 %). Patients with MS have a significant 1.7-fold increased risk of all-cause mortality compared with the general population. MS is the most commonly recorded cause of death among MS patients.

Show MeSH

Related in: MedlinePlus

a Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients <50 years at index date. MS multiple sclerosis. b Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients ≥50 years at index date. MS multiple sclerosis
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4119255&req=5

Fig1: a Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients <50 years at index date. MS multiple sclerosis. b Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients ≥50 years at index date. MS multiple sclerosis

Mentions: Patients aged ≥50 years at diagnosis had shorter survival than those aged <50 years at diagnosis (Fig. 1). For the latter group, an increasing difference in survival between MS cases and their matched non-MS referents was observed with increasing length of follow-up. Survival probabilities were similar for both male and female MS patients, with 10-year survival at 90 and 93 %, and 15-year survival at 86 and 87 % for males and females, respectively.Fig. 1


Mortality of patients with multiple sclerosis: a cohort study in UK primary care.

Jick SS, Li L, Falcone GJ, Vassilev ZP, Wallander MA - J. Neurol. (2014)

a Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients <50 years at index date. MS multiple sclerosis. b Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients ≥50 years at index date. MS multiple sclerosis
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4119255&req=5

Fig1: a Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients <50 years at index date. MS multiple sclerosis. b Kaplan–Meier plot for the survival probabilities (all-cause mortality) of patients ≥50 years at index date. MS multiple sclerosis
Mentions: Patients aged ≥50 years at diagnosis had shorter survival than those aged <50 years at diagnosis (Fig. 1). For the latter group, an increasing difference in survival between MS cases and their matched non-MS referents was observed with increasing length of follow-up. Survival probabilities were similar for both male and female MS patients, with 10-year survival at 90 and 93 %, and 15-year survival at 86 and 87 % for males and females, respectively.Fig. 1

Bottom Line: MS patients (N = 1,822) had a significantly increased risk of all-cause mortality compared with referents (N = 18,211); adjusted HR 1.7 (95 % CI 1.4-2.1).A significantly higher proportion of referents than MS patients had cancer recorded as cause of death (40 vs. 19 %).Patients with MS have a significant 1.7-fold increased risk of all-cause mortality compared with the general population.

View Article: PubMed Central - PubMed

Affiliation: Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, 11 Muzzey Street, Lexington, MA, 02421, USA, sjick@bu.edu.

ABSTRACT
We aimed to estimate rates, causes and risk factors of all-cause mortality in a large population-based cohort of multiple sclerosis (MS) patients compared with patients without MS. Using data from the UK General Practice Research Database, we identified MS cases diagnosed during 2001-2006 and validated using patients' original records where possible. We also included MS cases during 1993-2000 identified and validated in an earlier study. Cases were matched to up to ten referents without MS by age, sex, index date (date of first MS diagnosis for cases and equivalent reference date for controls), general practice and length of medical history before first MS diagnosis. Patients were followed up to identify deaths; hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox-proportional regression. MS patients (N = 1,822) had a significantly increased risk of all-cause mortality compared with referents (N = 18,211); adjusted HR 1.7 (95 % CI 1.4-2.1). Compared with referents, female MS patients had a higher but not significantly different HR for death than males; adjusted HR 1.86 (95 % CI 1.46-2.38) vs. HR 1.31 (95 % CI 0.93-1.84), respectively. The most commonly recorded cause of death in MS patients was 'MS' (41 %), with a higher proportion recorded among younger patients. A significantly higher proportion of referents than MS patients had cancer recorded as cause of death (40 vs. 19 %). Patients with MS have a significant 1.7-fold increased risk of all-cause mortality compared with the general population. MS is the most commonly recorded cause of death among MS patients.

Show MeSH
Related in: MedlinePlus