Fleming S T, Blake R L
University of Missouri, Columbia 65211, USA.
J Clin Epidemiol. 1994 Oct;47(10):1127-32. doi: 10.1016/0895-4356(94)90099-x.
This study explored the prevalence of comorbid conditions in hospitalized patients with multiple sclerosis (MS) who were 65 years of age or older. Using 1989 data from the Quality of Care Medicare Provider Analysis and Review (MEDPAR) file, hospitalized MS patients were compared with respect to discharge diagnoses to an age- and sex-matched group of hospitalized patients without MS. As expected, the following discharge diagnoses were more common (P < 0.05) for MS patients: urinary tract infection, pneumonia, septicemia and cellulitus. In contrast, MS patients were less likely (P < 0.05) to have discharge diagnoses of acute myocardial infarction, heart failure, hypertension, angina pectoris, cerebrovascular disease, diabetes mellitus and chronic obstructive pulmonary disease. Possible explanations include under-reporting of certain comorbid conditions on discharge records of MS patients, a protective effect of MS or its treatment, reduced prevalence of risk factors, disproportionate mortality in younger MS patients with comorbidity and the benefits of medical surveillance.
本研究探讨了65岁及以上住院多发性硬化症（MS）患者共病情况的患病率。利用1989年医疗保险医疗服务提供者分析与审查（MEDPAR）文件中的数据，将住院的MS患者与年龄和性别匹配的非MS住院患者的出院诊断进行了比较。不出所料，MS患者的以下出院诊断更为常见（P<0.05）：尿路感染、肺炎、败血症和蜂窝织炎。相比之下，MS患者出院诊断为急性心肌梗死、心力衰竭、高血压、心绞痛、脑血管疾病、糖尿病和慢性阻塞性肺疾病的可能性较小（P<0.05）。可能的解释包括MS患者出院记录中某些共病情况报告不足、MS或其治疗的保护作用、危险因素患病率降低、年轻合并症MS患者的不成比例死亡率以及医疗监测的益处。
