Nusrat Sanober, Levinthal David, Bielefeldt Klaus
University of Pittsburgh Medical Center, Division of Gastroenterology, 200 Lothrop Dr., Pittsburgh, PA 15213, USA.
Mult Scler Int. 2013;2013:436929. doi: 10.1155/2013/436929. Epub 2013 May 13.
Management of multiple sclerosis (MS) has shifted from supportive to disease modifying therapy. Considering the increasingly widespread adoption of this approach in managing MS patients, we hypothesized that hospitalizations and surrogates of disease-related complications should have declined during the last decade. Methods. Using the Nationwide Inpatient Sample, hospitalizations for MS and associated secondary diagnoses and procedures as well as discharge status were examined. Time trends were examined for different age cohorts focusing on the period from 2001 to 2010. Results. During the preceding decade, annual hospitalizations for MS increased by 40%, with stable rates in all age groups except geriatric patients, who accounted for a significantly higher fraction of admissions. Nursing home transfers as a surrogate marker of disability remained unchanged for all age groups. Similarly, urinary tract infections, the need for skin debridement, or gastrostomy tube placement did not vary during the decade. Conclusion. During a time of increased adoption of disease modifying therapy, MS-related hospitalizations continued to increase and surrogate measures of disability in admitted patients remained stable, demonstrating the still significant impact of the disease on affected individuals.
多发性硬化症（MS）的治疗已从支持性治疗转向疾病修正治疗。鉴于这种方法在MS患者管理中的应用日益广泛，我们推测在过去十年中，住院率及疾病相关并发症的替代指标应该有所下降。方法：利用全国住院患者样本，对MS住院患者、相关二级诊断和治疗以及出院状态进行了检查。针对不同年龄组，研究了2001年至2010年期间的时间趋势。结果：在过去十年中，MS的年度住院率上升了40%，除老年患者外，所有年龄组的住院率保持稳定，而老年患者的住院比例显著更高。作为残疾替代指标的疗养院转诊率在所有年龄组中均保持不变。同样，十年间尿路感染、皮肤清创需求或胃造瘘管置入情况也没有变化。结论：在疾病修正治疗应用增加的时期，与MS相关的住院率持续上升，住院患者的残疾替代指标保持稳定，这表明该疾病对患者仍有重大影响。
