Journal Article

Survival and cause of death in multiple sclerosis: a 60-year longitudinal population study

Lunde, Hanne Marie Bøe, Myhr, Kjell-Morten, Bø, Lars, Assmus, Jörg, Grytten, Nina

2017

Overview

ObjectiveSurvival and causes of death (COD) in multiple sclerosis (MS) provide ultimate endpoints. We aimed to investigate survival and COD in a 60-year population-based MS cohort compared with the general population.MethodsAll patients with incident multiple sclerosis (MS) (N=1388) with onset during 1953–2012 in Hordaland County, Western Norway, were included. Data were obtained from patient records at Haukeland University Hospital and linked to the Norwegian COD registry. Survival adjusted for sex, age and disease course were estimated by Kaplan-Meier analyses from birth and from disease onset. Mortality and COD in MS relative to the general population were examined by standardised mortality ratio (SMR).ResultsOf 1388 patients, 291 had deceased, mainly of MS (56.4%). Median life expectancy was 74.7 years for MS and 81.8 years for the general population (p<0.001); 77.2 years for women with MS and 72.2 years for men with MS (p<0.001). Life expectancy for patients with relapsing remitting MS (RRMS) was 77.8 years and ­71.4 years for primary progressive MS (PPMS) (p<0.001). Overall SMR was 2.7 (p>0.0001); 2.9 in women and 2.5 in men (p=0.0009). SMR was 2.4 in RRMS and 3.9 in PPMS (p<0.0001). SMR from disease onset during 1953–1974 was 3.1; 2.6 during 1975–1996 and 0.7 during 1997–2012 (p<0.0083). No difference in cause-specific deaths were found (p=0.0871).ConclusionWe found a 7-year shorter life expectancy and almost threefold higher mortality in MS compared with the general population. A rise in survival in MS was observed during the entire observation period.

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group LTD,Journal of Neurology, Neurosurgery, and Psychiatry
• Subject: Age / Age of Onset / Aged / Aged, 80 and over / Cardiovascular disease / Cause of Death / Comorbidity / Departments / Epidemiology / Female / Gender / Health risk assessment / Hospitals / Humans / Life Expectancy / Longitudinal Studies / Male / Medical prognosis / Middle Aged / Mortality / Multiple Sclerosis / Multiple Sclerosis - mortality / Multiple Sclerosis, Chronic Progressive - mortality / Multiple Sclerosis, Relapsing-Remitting - mortality / Neuroepidemiology / Neurology / Norway - epidemiology / Patients / Population / Population-based studies / Trends / Womens health