Abstract:
BACKGROUND:It has been suggested that comorbidity in subjects with multiple sclerosis (MS) increases the risk of hospitalizations, although few studies have examined this, and rarely in an incident population. METHODS:Incident MS cases were identified retrospectively from administrative data in Saskatchewan, Canada (1996 - 2017) using a validated definition (≥3 hospital, physician or drug claims for MS); the date of the first claim for MS or a demyelinating condition was considered the index date. All hospitalizations occurring after the index were included in the analyses. Comorbidity was defined in 3 ways: any comorbidity (yes/no); a total count of comorbidity (0, 1, or ≥2); and by individual comorbidities. The impact of comorbidity on all-cause hospitalizations was examined with negative binomial regression models fitted with generalized estimating questions. In subjects with at least one hospitalization during the follow-up period, we examined associations between comorbidity and MS-related hospitalizations logistic using regression models fitted with GEE. RESULTS:Subjects with comorbidity had a higher rate of all-cause hospitalizations compared to those without any comorbidity (aRR 1.72; 95% CI: 1.48-1.99); comorbidity did not increase the odds of having an MS-specific hospitalization (aOR 0.76; 95% CI: 0.59-0.99). Individual comorbidities including diabetes, ischemic heart disease, chronic lung disease, epilepsy, and mood disorders increased the rate of all-cause hospitalizations, but had little impact on MS-related hospitalizations. A longer disease duration was associated with decreased all-cause and MS-specific admissions. CONCLUSION:Comorbidity increased the rate of all-cause, but not MS-specific, hospital admissions. Hospitalization rates were higher during the earlier stages of MS. Therefore, recognizing and managing comorbidity in the MS population, especially early in the disease course, will likely have the biggest impact on reducing overall hospital admissions.
journal_name
Mult Scler Relat Disordjournal_title
Multiple sclerosis and related disordersauthors
Al-Sakran L,Marrie RA,Blackburn D,Knox K,Evans Cdoi
10.1016/j.msard.2020.101955subject
Has Abstractpub_date
2020-05-01 00:00:00pages
101955eissn
2211-0348issn
2211-0356pii
S2211-0348(20)30031-6journal_volume
40pub_type
杂志文章abstract:BACKGROUND:The discovery of two immunoglobulin G (IgG) antibodies against aquaporin 4 (anti-AQP4) and myelin oligodendrocyte glycoprotein (anti-MOG) has led to the distinction of the disorders anti-AQP4 immunoglobulin G positive neuromyelitis spectrum disorder (AQP4-IgG+ NMOSD) and anti-MOG associated disorder (MOGAD)....
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102718
更新日期:2020-12-24 00:00:00
abstract::Multiple Sclerosis is a chronic, progressive and debilitating neurological disease which, despite extensive study for over 100 years, remains of enigmatic aetiology. Drawn from the epidemiological evidence, there exists a consensus that there are environmental (possibly infectious) factors that contribute to disease p...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.06.014
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Balance impairment is common and a risk factor of falls in people with multiple sclerosis (MS). The purpose of this study was to evaluate the relative importance between vision and proprioception in maintaining standing body balance among individuals with MS compared with healthy individuals. METHODS:Thirty...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.101901
更新日期:2019-12-20 00:00:00
abstract:BACKGROUND:Few data exists on paediatric neuromyelitis optica spectrum disorder (NMOSD). Here, we investigated the clinical presentation, treatment responses and long-term prognoses in a large cohort of patients with NMOSD and compared between children and adults with aquaporin-4 antibody (AQP4-IgG). METHODS:A retrosp...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2018.12.038
更新日期:2019-02-01 00:00:00
abstract::Iatrogenic demyelination is a distinct clinical subtype of central nervous system inflammatory disorders. The Janus kinase inhibitor, tofacitinib, is an oral disease-modifying antirheumatic drug that has shown contradictory effects on multiple sclerosis in animal models. In this report, we describe a novel case of rev...
journal_title:Multiple sclerosis and related disorders
pub_type: 信件
doi:10.1016/j.msard.2020.102568
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Notoriously the treatment of multiple sclerosis (MS) is based on the use of several different drugs, characterized by a diverse mechanism of action, efficacy and safety. Recently, progress has been made towards developing new oral immunotherapies, and dimethyl fumarate is the third oral agent approved for th...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2016.03.009
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Several monoclonal antibodies have been licensed for relapsing remitting multiple sclerosis (RRMS). It is still unclear which treatment regimen should be recommended due to the lack of head-to-head randomized controlled trials (RCTs). This study aims to investigate the relative efficacy and safety of existin...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,meta分析
doi:10.1016/j.msard.2018.08.026
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Multiple sclerosis can cause cardiovascular autonomic dysfunction. It is assumed that is caused by multiple demyelinating plaques localized in the brain stem and spinal cord. Previous studies have determined this using tilt table test, heart rate responses to Valsalva maneuver and deep breathing and heart ra...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.06.012
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:There is no evidence that disease modifying therapies (DMTs) are beneficial in progressive (non-relapsing) MS. However, these patients may benefit from multidiscipliniary interventions, and require financial and community support. Non-pharmacological needs of MS patients may be overlooked during fund allocat...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2015.01.003
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Coronavirus disease 19 (COVID-19) is a novel disease entity that is spreading throughout the world. It has been speculated that patients with comorbidities and elderly patients could be at high risk for respiratory insufficiency and death. Immunosuppression could expose infected patients to even higher risks...
journal_title:Multiple sclerosis and related disorders
pub_type:
doi:10.1016/j.msard.2020.102120
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Fatigue is a common and disabling symptom of multiple sclerosis (MS) patients. Structural changes in several brain areas have been reported to correlate with fatigue in MS patients but none consistently. OBJECTIVE:To study the association between global and regional measures of brain atrophy and fatigue in ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2015.10.006
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Pain can interfere with the daily functioning of persons with multiple sclerosis (PwMS). Furthermore, beliefs about pain and activity engagement are reliably associated with persons' experience of chronic pain. This study aimed to explore the extent to which different aspects of PwMS' activity engagement is ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.101882
更新日期:2020-02-01 00:00:00
abstract::Acute relapses continue to be a significant aspect of multiple sclerosis (MS) on both the epidemiologic level and the individual patient level. Past work demonstrates residual disability from relapses as well as high patient-reported rates of ineffective relapse treatment. To better characterize the impact of MS relap...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2015.03.005
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Optic neuropathies (ON) have several aetiologies and sometimes the diagnosis established ab initio is redefined after further investigations and/or new neurological events. We aim with this study to report clinical, paraclinical findings, treatment choices and disease course in patients admitted with a suspi...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102337
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Many natalizumab treated patients experience end of dose interval (EDI) symptoms towards the end of the administration cycle. Natalizumab has previously shown to influence cytokine profiles in relapsing remitting MS patients. We hypothesize that EDI symptoms might be explained by variability in serum cytokin...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102020
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:We explored health-related quality of life (HRQoL) and psychosocial aspects in a cohort of patients with a history of longstanding benign MS (BMS). METHODS:Patients with BMS (EDSS≤3 after 20 years disease duration) were re-assessed 25-30 years post-MS symptom onset for: EDSS, HRQoL (MSQoL-54), depression (B...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2014.09.211
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:As vaccines for the coronavirus become available, it will be important to know the rate of COVID-19 vaccine acceptability in adults with multiple sclerosis (MS), given that vaccination will be a key strategy for preventing SARS-CoV-2 infections. Using a national sample of adults with MS in the United States ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2021.102788
更新日期:2021-01-22 00:00:00
abstract:BACKGROUND:In multiple sclerosis (MS) the quantitative role of relapses in Expanded Disability Status Scale (EDSS) worsening beyond the recovery phase is not well known. Most studies have examined the predictive role of early relapses in more distant endpoints. Relapses and worsening may be associated because they coul...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.04.017
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Neuromyelitis optica (NMO) is a disabling inflammatory condition that targets astrocytes in the optic nerves and spinal cord. Recent advances led to the individualization of a set of conditions now referred as NMO spectrum disorder (NMOSD). OBJECTIVE:To describe the prevalence and characteristics of NMO SD ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2015.12.005
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Disease-modifying therapy (DMT) for patients with relapsing-remitting multiple sclerosis (RRMS) have been shown to reduce relapses and new MRI lesions. However, few studies have assessed the impact of discontinuing DMT after a period of disease inactivity. OBJECTIVE:To investigate the impact of DMT disconti...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.07.021
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The corpus callosum index (CCI) can be easily and reliably obtained from conventional magnetic resonance imaging (MRI) and has been proposed as a possible marker of brain atrophy in MS. However, further validation of its correlation with volumetric measurements is still warranted. OBJECTIVE:To assess the co...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.01.015
更新日期:2018-02-01 00:00:00
abstract::Despite having a high rate of occurrence, erythroblast appearance in peripheral blood may not be a recognized adverse effect of natalizumab (NTZ) treatment. Additionally, the time course and cause of erythroblast appearance remain unclear. We report two cases of multiple sclerosis wherein NTZ treatment led to erythrob...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.01.041
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of intravenous immunoglobulins (IVIG) on prevention of postpartum relapses in women with relapsing-remitting multiple sclerosis (RRMS). METHODS:This was a retrospective study performed in Ljubljana, Slovenia where the practice for all pregnant women with RRMS is to receive IVIG after ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2019.101519
更新日期:2020-02-01 00:00:00
abstract::The identification of AQP4-IgG, a specific and pathogenic antibody of NMO/SD has led to a broadening of the clinical spectrum of manifestations of NMO/SD including the presence of encephalic symptoms. Lesions are often distributed on peri‑ependymal area and sometimes affected the diencephalon leading to sleep disorder...
journal_title:Multiple sclerosis and related disorders
pub_type:
doi:10.1016/j.msard.2019.101869
更新日期:2020-02-01 00:00:00
abstract::Neuromyelitis optica spectrum disorder (NMOSD) is a common neuroinflammatory demyelinating disease associated with aquaporin-4 (AQP4) antibody in the central nervous system. Neurosyphilis is a neurological disease caused by Treponema pallidum infection. NMOSD commonly occurs concurrently with autoimmune diseases. Howe...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.06.028
更新日期:2019-09-01 00:00:00
abstract::Neuromyelitis optica is a severe autoimmune demyelinating disease; however, the trigger for autoimmunity in an individual patient is unclear. Here, we report the case of a 48 year old female presenting with longitudinally extensive transverse myelitis in the cervical region of the spinal cord two weeks post herpes zos...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.09.022
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:Ocrelizumab inhibits relapsing multiple sclerosis when administered every six months. Based on potential similar memory B cell depletion mechanisms with cladribine and alemtuzumab, we hypothesised that CD20-depletion of B cells by ocrelizumab may exhibit a duration of response exceeding the current licenced t...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2020.102279
更新日期:2020-09-01 00:00:00
abstract::Multiple sclerosis (MS) is a complex chronic immune disease in the central nervous system, causing neurological disability among young and middle-aged adults. Impaired cognition is now emerging as a major clinical symptom being present in more than 50% of MS patients. Recent data support that neuroinflammation mediate...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2020.102622
更新日期:2020-11-14 00:00:00
abstract:BACKGROUND:Disturbances that occur in patients with multiple sclerosis (MS) are not restricted to motor, sensory, or urinary functions; they also include cognitive dysfunction, fatigue, and depression. Moreover, people with MS are known to have fewer social activities and a reduced quality of life. One aspect of social...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2014.02.001
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Although multiple sclerosis (MS) is frequent in the northern hemisphere, there have not been recent epidemiological studies in the Scottish Highlands about MS. OBJECTIVES:To get updated data regarding MS prevalence, incidence and mortality in the Highlands. Time between symptom onset and MS diagnosis was ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102657
更新日期:2020-11-28 00:00:00