Kuutti Katariina, Laakso Sini M, Viitala Matias, Atula Sari, Soilu-Hänninen Merja
Department of Neurology, Turku University Hospital, Turku, Finland.
Clinical Neurosciences, University of Turku, Turku, Finland.
J Neurol. 2025 May 2;272(5):370. doi: 10.1007/s00415-025-13112-1.
Population-based longitudinal data on mortality and causes of death (COD) for people with Multiple Sclerosis (pwMS) is scarce. We studied all-cause and cause-specific mortality in Finnish pwMS in a nationwide registry study.
PwMS from 1st January 1971 until end of 2019 were identified from the Finnish MS registry and national health care register. Standardized mortality ratios (SMRs), excess death rates (EDRs), life expectancies, and causes of death (COD) were determined by linkage to national registries.
For 16,602 pwMS, 3936 deaths occurred between 1980 and 2020. During 1980-1999, SMR for pwMS was 3.07 (95% CI 2.91-3.25) and EDR 14.05 (95% CI 13.72-14.37), and during 2000-2020 2.18 (95% CI 2.10-2.26) and 7.48 (95% CI 7.2-7.75), respectively. SMRs were higher for female pwMS and for patients diagnosed under age 30. EDRs were higher for males. Risk of death was lower for pwMS diagnosed 1996-2005 versus 1980-1995 (HR 0.49; 95% CI 0.43-0.55; p < 0.001). MS was the underlying cause in 51.2%, and a mentioned cause in 73.1% of deaths during 2000-2020. Mortality by underlying cause was higher than expected for gastrointestinal diseases (SMR 2.15, 95% CI 1.53-2.77), respiratory infections (SMR 1.99, 95% CI 1.22-2.75), and vascular diseases (SMR 1.38, 95% CI 1.25-1.51). Median lifetime expectancy was shortened by 7 years.
Excess mortality in Finnish pwMS has decreased during the last 40 years. Life expectancy is shortened by 7 years and MS itself is the most frequent underlying COD. Risk of death is lower for pwMS diagnosed during the therapeutic era.
关于多发性硬化症患者（pwMS）死亡率和死亡原因（COD）的基于人群的纵向数据稀缺。我们在一项全国性登记研究中对芬兰pwMS的全因死亡率和特定原因死亡率进行了研究。
从芬兰多发性硬化症登记处和国家医疗保健登记处识别出1971年1月1日至2019年底的pwMS。通过与国家登记处的关联确定标准化死亡率（SMR）、超额死亡率（EDR）、预期寿命和死亡原因（COD）。
对于16,602例pwMS，1980年至2020年间发生了3936例死亡。在1980 - 1999年期间，pwMS的SMR为3.07（95%CI 2.91 - 3.25），EDR为14.05（95%CI 13.72 - 14.37），而在2000 - 2020年期间分别为2.18（95%CI 2.10 - 2.26）和7.48（95%CI 7.2 - 7.75）。女性pwMS和30岁以下诊断的患者SMR更高。男性的EDR更高。1996 - 2005年诊断的pwMS与1980 - 1995年诊断的相比，死亡风险更低（HR 0.49；95%CI 0.43 - 0.55；p < 0.001）。在2000 - 2020年期间，MS是51.2%的死亡的根本原因，且在73.1%的死亡中被提及为原因。按根本原因分类的死亡率高于预期的有胃肠道疾病（SMR 2.15，95%CI 1.53 - 2.77）、呼吸道感染（SMR 1.99，95%CI 1.22 - 2.75）和血管疾病（SMR 1.38，95%CI 1.25 - 1.51）。中位预期寿命缩短了7年。
在过去40年中，芬兰pwMS的超额死亡率有所下降。预期寿命缩短了7年，MS本身是最常见的根本死亡原因。在治疗时代诊断的pwMS死亡风险更低。
