Mortality of patients with multiple sclerosis: a cohort study in UK primary care
2014 (English)In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 261, no 8, 1508-1517 p.Article in journal (Refereed) Published
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.
Place, publisher, year, edition, pages
2014. Vol. 261, no 8, 1508-1517 p.
Multiple sclerosis, Epidemiology, Cause of death, Cohort analysis, Mortality
IdentifiersURN: urn:nbn:se:uu:diva-231240DOI: 10.1007/s00415-014-7370-3ISI: 000340052000008OAI: oai:DiVA.org:uu-231240DiVA: diva2:744554
Erratum in Journal of Neurology, 2014:261, issue 8, pp 1518-1521, doi: 10.1007/s00415-014-7421-92014-09-082014-09-052014-09-08Bibliographically approved