Dataset Information

Non-infectious comorbidity in patients with multiple sclerosis: A national cohort study in Sweden.

ABSTRACT: Background:Comorbidity is of significant concern in multiple sclerosis (MS). Few population-based studies have reported conditions occurring in MS after diagnosis, especially in contemporary cohorts. Objective:To explore incident comorbidity, mortality and hospitalizations in MS, stratified by age and sex. Methods:In a Swedish population-based cohort study 6602 incident MS patients (aged ?18?years) and 61,828 matched MS-free individuals were identified between 1 January 2008 and 31 December 2016, using national registers. Incidence rates (IRs) and incidence rate ratios (IRRs) with 95% CI were calculated for each outcome. Results:IRs of cardiovascular disease (CVD) were higher among MS patients than MS-free individuals, (major adverse CVD: IRR 1.42; 95% CI 1.12-1.82; hemorrhagic/ischemic stroke: 1.46; 1.05-2.02; transient ischemic attack: 1.65; 1.09-2.50; heart failure: 1.55; 1.15-2.10); venous thromboembolism: 1.42; 1.14-1.77). MS patients also had higher risks of several non-CVDs such as autoimmune conditions (IRR 3.83; 3.01-4.87), bowel dysfunction (2.16; 1.86-2.50), depression (2.38; 2.11-2.68), and fractures (1.32; 1.19-1.47), as well as being hospitalized and to suffer from CVD-related deaths ((1.91; 1.00-3.65), particularly in females (3.57; 1.58-8.06)). Conclusion:MS-patients experience a notable comorbidity burden which emphasizes the need for integrated disease management in order to improve patient care and long-term outcomes of MS.

SUBMITTER: Castelo-Branco A

PROVIDER: S-EPMC7430080 | biostudies-literature | 2020 Jul-Sep

REPOSITORIES: biostudies-literature

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Non-infectious comorbidity in patients with multiple sclerosis: A national cohort study in Sweden.

Castelo-Branco Anna A Chiesa Flaminia F Bengtsson Camilla E CE Lee Sally S Minton Neil N NN Niemcryk Steve S Lindholm Anders A Rosenlund Mats M Piehl Fredrik F Montgomery Scott S

Multiple sclerosis journal - experimental, translational and clinical 20200701 3

<h4>Background</h4>Comorbidity is of significant concern in multiple sclerosis (MS). Few population-based studies have reported conditions occurring in MS after diagnosis, especially in contemporary cohorts.<h4>Objective</h4>To explore incident comorbidity, mortality and hospitalizations in MS, stratified by age and sex.<h4>Methods</h4>In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years) and 61,828 matched MS-free individuals were identified between 1 January 200 ...[more]

PMID: 32864156

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Project description:ObjectivesTo explore sequences of annual states of activity and sickness absence (SA) or disability pension (DP) (SA/DP) among working-aged people with multiple sclerosis (PwMS) as well as characteristics associated with the identified types of working-life sequences.DesignNationwide Swedish register-based cohort study from 1 year prior to 5 years after the year of multiple sclerosis (MS) diagnosis.SettingSweden.ParticipantsPwMS diagnosed in 2008-2011 when aged 20-55 (n=2652, 69.9% women).Primary and secondary outcome measuresIndividual-level sequences spanning 7 years were constructed with annual states regarding activity (income from paid work, student allowances, parental leave or unemployment compensation) and/or SA/DP. Types of working-life sequences were identified among the individuals' sequences using hierarchical cluster analysis with optimal matching dissimilarity measures.ResultsSix types of working-life sequences were identified. The largest cluster, Stable High Activity, represented 48.4% of the cohort. Other types were: Stable High SA/DP (14.5%); Other (4.5%); and three types with mixed activity and varying SA/DP regarding the number of days/year and timing (32.6%). Characteristics of the different identified types of sequences were subsequently investigated. All types of sequences had lower odds for university education (OR range: 0.18-0.72) compared with Stable High Activity. Increasingly higher odds of having anxiety/depression compared with Stable High Activity were observed across the types of sequences, by increasing proportions of SA/DP. Stable High SA/DP sequences were less likely than Stable High Activity to be prescribed MS drugs in the MS diagnosis year (OR 0.61; 95% CI 0.47 to 0.78). All types of sequences had higher disposable income in the final study year than the first, except for Stable High SA/DP sequences (Swedish Krona 4669, 95% CI -1892 to 11 230).ConclusionsDiversity in working life was influenced by sociodemographic and clinical characteristics resulting in different activity and SA/DP patterns across the six identified types of working-life sequences.

Dataset Information

Non-infectious comorbidity in patients with multiple sclerosis: A national cohort study in Sweden.

Publications

Non-infectious comorbidity in patients with multiple sclerosis: A national cohort study in Sweden.

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