Multiple sclerosis (Houndmills, Basingstoke, England) · 2025
Assessing the association between mortality and clinical follow-up visits in multiple sclerosis.
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Beczek Agata, Landt Eskild Morten, Magyari Melinda, Storr Lars Kristian, Dahl Morten
Аннотация
BACKGROUND: The relationship between attendance at specialized multiple sclerosis (MS) clinics and mortality has not been fully evaluated.
OBJECTIVE: We investigated the association between visits to specialized care in Danish MS clinics and mortality.
METHODS: We collected data from Danish national registers to assess survival among people with MS according to the number of visits in MS clinics. We employed the Kaplan-Meier method and extended Cox regression modelling.
RESULTS: In total, 9929 patients with MS were included in the study, contributing 105 115 person-years at risk. A total of 316 patients with MS died during a median follow-up of 10.3 years. Cumulative visits were not statistically associated with mortality (hazard ratio (HR), 95% confidence interval (CI) = 1.00, 0.99-1.02). Female sex (0.68, 0.53-0.87), being divorced (0.56, 0.37-0.86), being married or in a partnership (0.60, 0.45-0.79) and higher education (0.64, 0.45-0.91) were independently associated with reduced mortality. Expanded Disability Status Scale (EDSS) ⩾ 3 (2.38, 1.60-3.54), ischaemic cerebrovascular disease (1.97, 1.42-2.75) and pneumonia (7.03, 5.48-9.02) were associated with an increased mortality.
CONCLUSION: We found no association between visits to specialized care and mortality. Our findings suggest that improving survival in patients with MS may require a focus on quality and content of care and proactive management of comorbidities.
OBJECTIVE: We investigated the association between visits to specialized care in Danish MS clinics and mortality.
METHODS: We collected data from Danish national registers to assess survival among people with MS according to the number of visits in MS clinics. We employed the Kaplan-Meier method and extended Cox regression modelling.
RESULTS: In total, 9929 patients with MS were included in the study, contributing 105 115 person-years at risk. A total of 316 patients with MS died during a median follow-up of 10.3 years. Cumulative visits were not statistically associated with mortality (hazard ratio (HR), 95% confidence interval (CI) = 1.00, 0.99-1.02). Female sex (0.68, 0.53-0.87), being divorced (0.56, 0.37-0.86), being married or in a partnership (0.60, 0.45-0.79) and higher education (0.64, 0.45-0.91) were independently associated with reduced mortality. Expanded Disability Status Scale (EDSS) ⩾ 3 (2.38, 1.60-3.54), ischaemic cerebrovascular disease (1.97, 1.42-2.75) and pneumonia (7.03, 5.48-9.02) were associated with an increased mortality.
CONCLUSION: We found no association between visits to specialized care and mortality. Our findings suggest that improving survival in patients with MS may require a focus on quality and content of care and proactive management of comorbidities.