Simpson Robert J, McLean Gary, Guthrie Bruce, Mair Frances, Mercer Stewart W
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, Scotland, UK.
BMC Neurol. 2014 Jun 13;14:128. doi: 10.1186/1471-2377-14-128.
Comorbidity in Multiple Sclerosis (MS) is associated with worse health and higher mortality. This study aims to describe clinician recorded comorbidities in people with MS.
39 comorbidities in 3826 people with MS aged ≥25 years were compared against 1,268,859 controls. Results were analysed by age, gender, and socioeconomic status, with unadjusted and adjusted Odds Ratios (ORs) calculated using logistic regression.
People with MS were more likely to have one (OR 2.44; 95% CI 2.26-2.64), two (OR 1.49; 95% CI 1.38-1.62), three (OR 1.86; 95% CI 1.69-2.04), four or more (OR 1.61; 95% CI 1.47-1.77) non-MS chronic conditions than controls, and greater mental health comorbidity (OR 2.94; 95% CI 2.75-3.14), which increased as the number of physical comorbidities rose. Cardiovascular conditions, including atrial fibrillation (OR 0.49; 95% CI 0.36-0.67), chronic kidney disease (OR 0.51; 95% CI 0.40-0.65), heart failure (OR 0.62; 95% CI 0.45-0.85), coronary heart disease (OR 0.64; 95% CI 0.52-0.71), and hypertension (OR 0.65; 95% CI 0.59-0.72) were significantly less common in people with MS.
People with MS have excess multiple chronic conditions, with associated increased mental health comorbidity. The low recorded cardiovascular comorbidity warrants further investigation.
多发性硬化症(MS)合并症与健康状况较差和死亡率较高相关。本研究旨在描述临床医生记录的MS患者的合并症情况。
将3826名年龄≥25岁的MS患者的39种合并症与1268859名对照进行比较。结果按年龄、性别和社会经济状况进行分析,使用逻辑回归计算未调整和调整后的优势比(OR)。
与对照组相比,MS患者更有可能患有一种(OR 2.44;95%CI 2.26 - 2.64)、两种(OR 1.49;95%CI 1.38 - 1.62)、三种(OR 1.86;95%CI 1.69 - 2.04)、四种或更多(OR 1.61;95%CI 1.47 - 1.77)非MS慢性疾病,且心理健康合并症更严重(OR 2.94;95%CI 2.75 - 3.14),随着身体合并症数量的增加而增加。心血管疾病,包括心房颤动(OR 0.49;95%CI 0.36 - 0.67)、慢性肾病(OR 0.51;95%CI 0.40 - 0.65)、心力衰竭(OR 0.62;95%CI 0.45 - 0.85)、冠心病(OR 0.64;95%CI 0.52 - 0.71)和高血压(OR 0.65;95%CI 0.59 - 0.72)在MS患者中明显不常见。
MS患者存在多种慢性疾病,且心理健康合并症增加。记录的心血管合并症较低值得进一步研究。