[Multiple sclerosis in continental Portugal: analysis of spatio-temporal clusters and spatial variations in time trends of hospitalised patients between 2002 and 2013].

INTRODUCTION

Multiple sclerosis (MS) is a demyelinating and autoimmune disease with variable progression and high risk of hospital admission. In some studies these hospitalizations may be used as surrogate markers of disease progression, however in Portugal, due to organizational asymmetries and clinical safety choices this relationship is not linear. The admission patterns for this pathology can provide relevant data to the design of disease's management strategies and resource allocation.

AIM

To characterize hospital admissions for MS in mainland Portugal between 2002 and 2013 through the cases included in the hospital morbidity database with the code ICD-9-CM 340 as primary diagnosis.

PATIENTS AND METHODS

In this study mapping techniques, analysis of spatio-temporal clusters and analysis of spatial variations in temporal trends of hospital admission rates for MS were used.

RESULTS

Between 2002 and 2013 the rate of annual hospital admission for MS was 82.2/100,000 hospitalizations, with a decreasing trend of 3.73%/year. Seven spatial-temporal clusters were identified with hospital admission rates for this pathology ranging from 2.27 to 4.23 higher than the national rate. In addition, in this time period four areas with increasing trend in hospital admission rate (+ 0.17 to +11.5%) were detected: Sintra-Cascais-Amadora, Serra da Estrela, Alentejo-Algarve and Tras-os-Montes.

CONCLUSION

These data demonstrate the expected asymmetry of organizational differences, environmental, genetic and clinical safety choices. This study allowed the identification of areas and evolutionary trends of hospital admission rates for MS, enabling the design of more focused health interventions.