Highlights
- •64% of the patients die of MS-related causes.
- •Overall SMR: 2.52; PPMS: 4.10, RR/SPMS: 2.34.
- •The excess mortality rate is solely caused by excess death rate due to MS.
- •This is the first study from Central-Eastern Europe.
Abstract
Objective
We aimed to assess the causes of death, the mortality and survival time of MS patients
in Hungary.
Patients and methods
Between 1993 and 2013, 740 patients (10,303 person-years) were treated at our Outpatients' Clinic, of which 121 died. The causes
of death were established from the pathological records or the medical certificates
of the cause of death. The standardized mortality ratios (SMR) were calculated. Survival
time was assessed with Gehan-Breslow test.
Results
Sixty-four percent of our patients died of MS-related causes. The SMR was 2.52. Primary
progressive (PPMS) patients' SMR was higher (4.10) than initially relapsing patients'
(RR/SPMS) was. There was no difference between the genders (2.46 for men vs 2.57 for
women). The median survival time of woman was 3 years longer (p < 0.001). RR/SPMS patients' median survival (35 years) was more than twice as long as PPMS patients' (14 years).
Discussion
The frequency of the MS-related cause of death, SMR and the median survival times
were mostly similar to previous results from Scandinavia and North-America, despite
the very different socio-economic backgrounds of these areas which shows that the
survival risk can solely be attributed to MS itself. These are the first data on the
topic from Central-Eastern-Europe.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Multiple sclerosis in Nord-Trondelag County, Norway: a prevalence and incidence study.Acta Neurol. Scand. 2004; 109: 378-384
- Prevalence of multiple sclerosis in the province of Teruel, Spain.J. Neurol. 1997; 244: 182-185
- Prevalence of multiple sclerosis in Csongrad County, Hungary.Acta Neurol. Scand. 2014; 130: 277-282
- Sex ratio of multiple sclerosis in the National Swedish MS Register (SMSreg).Mult. Scler. 2013; 19: 46-52
- Change in sex ratio, disease course and age at diagnosis in Oslo MS patients through seven decades.Acta Neurol. Scand. Suppl. 2009; 27-9
- Causes of death among patients with multiple sclerosis.Mult. Scler. 2010; 16: 1437-1442
- Cause-specific mortality in type 2 diabetes. The Verona Diabetes Study.Diabetes Care. 1999; 22: 756-761
- Survival pattern and cause of death in patients with multiple sclerosis: results from an epidemiological survey in north east Scotland.J. Neurol. Neurosurg. Psychiatry. 1987; 50: 523-531
- Trends in survival and cause of death in Danish patients with multiple sclerosis.Brain. 2004; 127: 844-850
- Cause of death in patients attending multiple sclerosis clinics.Neurology. 1991; 41: 1193-1196
- Long-term survival of patients with multiple sclerosis in West France.Mult. Scler. 2007; 13: 865-874
- Survival and cause of death in multiple sclerosis: results from a 50-year follow-up in Western Norway.Mult. Scler. 2008; 14: 1191-1198
- New diagnostic criteria for multiple sclerosis: guidelines for research protocols.Ann. Neurol. 1983; 13: 227-231
- Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis.Ann. Neurol. 2001; 50: 121-127
- Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis.Neurology. 1996; 46: 907-911
- Simple parametric and nonparametric models for excess and relative mortality.Biometrics. 1989; 45: 523-535
- Excess mortality and cause of death in a cohort of Norwegian multiple sclerosis patients.Mult. Scler. 2009; 15: 1263-1270
- Survival and cause of death in multiple sclerosis: a prospective population-based study.J. Neurol. Neurosurg. Psychiatry. 2008; 79: 1016-1021
- Multiple sclerosis mortality and patterns of comorbidity in the United States from 1990 to 2001.Neuroepidemiology. 2006; 26: 102-107
- Underlying cause of death in Danish patients with multiple sclerosis: results from the Danish Multiple Sclerosis Registry.J. Neurol. Neurosurg. Psychiatry. 1998; 65: 56-59
- Cause of death in MS: long-term follow-up of a randomised cohort, 21 years after the start of the pivotal IFNbeta-1b study.BMJ Open. 2012; 2
- Mortality in patients with multiple sclerosis.Neurology. 2013; 81: 184-192
- Survival of multiple sclerosis in Finland between 1964 and 1993.Mult. Scler. 2002; 8: 350-355
- Suicide among Danes with multiple sclerosis.J. Neurol. Neurosurg. Psychiatry. 2005; 76: 1457-1459
- Elevated suicide risk among patients with multiple sclerosis in Sweden.Neuroepidemiology. 2003; 22: 146-152
- Multiple sclerosis survival: a population-based study in Sicily.Eur. J. Neurol. 2010; 17: 391-397
- Relative mortality and survival in multiple sclerosis: findings from British Columbia, Canada.J. Neurol. Neurosurg. Psychiatry. 2012; 83: 61-66
- Disability and survival of multiple sclerosis in Saskatoon, Saskatchewan.Can. J. Neurol. Sci. 2010; 37: 28-35
Article info
Publication history
Published online: June 16, 2016
Accepted:
June 15,
2016
Received in revised form:
June 9,
2016
Received:
May 10,
2016
Identification
Copyright
© 2016 Published by Elsevier B.V.
