Turner Aaron P, Hartoonian Narineh, Maynard Charles, Leipertz Steven L, Haselkorn Jodie K
VA Puget Sound Health Care System, Seattle, WA; VA Multiple Sclerosis Center of Excellence West, Seattle, WA; VA Center of Excellence in Substance Abuse Treatment and Education, Seattle, WA; Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA.
VA Puget Sound Health Care System, Seattle, WA; VA Multiple Sclerosis Center of Excellence West, Seattle, WA; Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA.
Arch Phys Med Rehabil. 2015 Mar;96(3):402-9. doi: 10.1016/j.apmr.2014.10.014. Epub 2014 Nov 6.
To examine 2 modifiable health behaviors-smoking and physical activity-and their relationship to mortality among individuals with multiple sclerosis (MS).
Secondary analysis of Large Health Survey.
Data were obtained from a linkage of the Veterans Affairs (VA) MS National Data Repository, containing information on service provision to all individuals with MS receiving health services within the U.S. Department of Veterans Affairs; the VA 1999 Large Health Survey, containing information on smoking and physical activity; and the VA Vital Status File. All-cause mortality was examined for the 15-year period from 1999 through 2013.
Participants (N=2994) with MS who completed the Large Health Survey containing information on smoking and physical activity.
Not applicable.
Survival.
There were 1500 deaths (50.1%) during the study period. Cox proportional hazard analyses were conducted to examine the association between smoking and physical activity and 15-year mortality. After adjusting for demographic factors, physical functioning, mental health, and comorbid medical conditions, baseline smoking was associated with greater mortality (hazard ratio [HR]=1.38; 95% confidence interval [CI], 1.184-1.60). Higher levels of baseline physical activity were associated with lower mortality (activity 1-2 times/wk: HR=.64; 95% CI, .518-.798; activity ≥3 times/wk: HR=.53; 95% CI, .388-.715).
Results suggest that modifiable health behaviors represent a promising opportunity for intervention to improve the lives of individuals with MS.
研究两种可改变的健康行为——吸烟和体育活动——及其与多发性硬化症（MS）患者死亡率的关系。
对大型健康调查进行二次分析。
数据来自退伍军人事务部（VA）MS国家数据存储库的链接，该存储库包含向在美国退伍军人事务部接受医疗服务的所有MS患者提供服务的信息；VA 1999年大型健康调查，包含吸烟和体育活动的信息；以及VA生命状态文件。对1999年至2013年的15年期间的全因死亡率进行了研究。
完成包含吸烟和体育活动信息的大型健康调查的MS患者（N = 2994）。
不适用。
生存率。
研究期间有1500人死亡（50.1%）。进行Cox比例风险分析以研究吸烟和体育活动与15年死亡率之间的关联。在调整了人口统计学因素、身体功能、心理健康和合并症后，基线吸烟与更高的死亡率相关（风险比[HR]=1.38；95%置信区间[CI]，1.184 - 1.60）。较高水平的基线体育活动与较低的死亡率相关（每周活动1 - 2次：HR = 0.64；95% CI，0.518 - 0.798；每周活动≥3次：HR = 0.53；95% CI，0.388 - 0.715）。
结果表明，可改变的健康行为是改善MS患者生活的一个有前景的干预机会。
