Marrie Ruth Ann, Elliott Lawrence, Marriott James, Cossoy Michael, Tennakoon Aruni, Yu Nancy
From the Departments of Internal Medicine (R.A.M., J.M., M.C., A.T., N.Y.) and Community Health Sciences (R.A.M., L.E.), University of Manitoba, Winnipeg, Canada.
Neurology. 2015 Jan 27;84(4):350-8. doi: 10.1212/WNL.0000000000001187. Epub 2014 Dec 24.
We aimed to evaluate the association between comorbidity and rates of hospitalization in the multiple sclerosis (MS) population as compared to a matched cohort from the general population.
Using population-based administrative data from the Canadian province of Manitoba, we identified 4,875 persons with MS and a matched general population cohort of 24,533 persons. We identified all acute care hospitalizations in the period 2007-2011. Using general linear models, we evaluated the association between comorbidity status and hospitalization rates (all-cause, non-MS-related, MS-related) in the 2 populations, adjusting for age, sex, and socioeconomic status.
Comorbidity was common in both cohorts. Over the 5-year study period, the MS population had a 1.5-fold higher hospitalization rate (adjusted rate ratio [aRR] 1.56; 95% confidence interval [CI] 1.44-1.68) than the matched population. Any comorbidity was associated with a 2-fold increased risk of non-MS-related hospitalization rates (aRR 2.21; 95% CI 1.73-2.82) in the MS population, but a nearly 4-fold increase in hospitalization rates in the matched population (aRR 3.85; 95% CI 3.40-4.35). Comorbidity was not associated with rates of hospitalization for MS-related reasons, regardless of how comorbidity status was defined.
In the MS population, comorbidity is associated with an increased risk of all-cause hospitalizations, suggesting that the prevention and management of comorbidity may reduce hospitalizations.
我们旨在评估与普通人群匹配队列相比,多发性硬化症(MS)患者合并症与住院率之间的关联。
利用加拿大曼尼托巴省基于人群的行政数据,我们确定了4875名MS患者以及24533名匹配的普通人群队列。我们确定了2007 - 2011年期间所有的急性护理住院情况。使用一般线性模型,我们评估了这两个人群中合并症状态与住院率(全因、非MS相关、MS相关)之间的关联,并对年龄、性别和社会经济地位进行了调整。
两个队列中合并症都很常见。在5年的研究期间,MS人群的住院率比匹配人群高1.5倍(调整率比[aRR] 1.56;95%置信区间[CI] 1.44 - 1.68)。在MS人群中,任何合并症与非MS相关住院率增加2倍的风险相关(aRR 2.21;95% CI 1.73 - 2.82),但在匹配人群中住院率增加近4倍(aRR 3.85;95% CI 3.40 - 4.35)。无论合并症状态如何定义,合并症与MS相关原因导致的住院率均无关。
在MS人群中,合并症与全因住院风险增加相关,这表明合并症的预防和管理可能会减少住院次数