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患有先前败血症的患者发生非多发性硬化性脱髓鞘综合征的风险增加:一项全国性回顾性队列研究。

Increased risk of non-multiple sclerosis demyelinating syndromes in patients with preexisting septicaemia: a nationwide retrospective cohort study.

机构信息

Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China.

Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.

出版信息

Postgrad Med J. 2019 Jun;95(1124):307-313. doi: 10.1136/postgradmedj-2019-136667. Epub 2019 Jun 17.

Abstract

BACKGROUND

Growing evidence shows links between septicaemia and non-multiple sclerosis demyelinating syndromes (NMSDS); nevertheless, epidemiological data are still very limited. This study aimed to explore the relationship between septicaemia and NMSDS in a general population.

METHODS

The study included 482 781 individuals diagnosed with septicaemia and 1 892 825 age/sex-matched non-septicaemia patients for the comparison. Data were drawn from a population-based nationwide National Health Insurance Research Database Taiwan, from 1 January 2002 to 31 December 2011. The two cohorts of patients with and without septicaemia were followed up for the occurrence of NMSDS. The Cox-proportional hazard regression model was performed to estimate adjusted HR after multivariate adjustment.

RESULTS

Individuals with septicaemia had a 4.17-fold (95% CI 3.21 to 5.4, p < 0.001) higher risk to develop NMSDS compared with those without septicaemia. Patients aged <65 years had a greater NMSDS risk (<45 years: HR = 6.41, 95% CI 3.65 to 11.3, p < 0.001; 45-64 years: HR = 6.66, 95% CI 3.98 to 11.2, p < 0.001). Furthermore, females with septicaemia and individuals with higher severity of septicaemia were associated with increased risks of developing NMSDS.

CONCLUSIONS

Our results indicated that patients with septicaemia were likely to develop NMSDS. A possible contributing role of septicaemia in increasing the hazard of NMSDS is proposed, based on the outcome that individuals with higher severity of septicaemia carried elevated threat of encountering NMSDS.

摘要

背景

越来越多的证据表明败血症与非多发性硬化脱髓鞘综合征(NMSDS)之间存在关联;然而,流行病学数据仍然非常有限。本研究旨在探索普通人群中败血症与 NMSDS 之间的关系。

方法

该研究纳入了 482781 例败血症患者和 1892825 例年龄/性别匹配的非败血症患者进行比较。数据来自 2002 年 1 月 1 日至 2011 年 12 月 31 日的一项基于人群的全国性全民健康保险研究数据库(台湾)。对败血症和非败血症患者两组患者进行了 NMSDS 发病情况的随访。采用 Cox 比例风险回归模型进行多变量调整后,估计调整后的 HR。

结果

与非败血症患者相比,败血症患者发生 NMSDS 的风险高出 4.17 倍(95%CI 3.21 至 5.4,p<0.001)。年龄<65 岁的患者 NMSDS 风险更高(<45 岁:HR=6.41,95%CI 3.65 至 11.3,p<0.001;45-64 岁:HR=6.66,95%CI 3.98 至 11.2,p<0.001)。此外,患有败血症的女性和败血症严重程度较高的患者发生 NMSDS 的风险增加。

结论

我们的研究结果表明败血症患者更易发生 NMSDS。败血症可能会增加 NMSDS 的发病风险,这是基于败血症严重程度较高的患者发生 NMSDS 的风险升高的结果得出的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8db5/6613738/d3e1bcdf2c1b/postgradmedj-2019-136667f01.jpg

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