End of life in multiple sclerosis: Disability, causes and place of death among cases diagnosed from 1981 to 2010 in Pirkanmaa hospital district in Western Finland

Murtonen, Annukka; Lehto, Juho T.; Sumelahti, Marja Liisa

doi:10.1016/j.msard.2021.103139

Cited by 2 publications

(3 citation statements)

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“…In this longitudinal study, we found shortened lifespans and excess mortality in pwMS, corroborating the findings from a recent meta-analysis 6. Approximately, 8 out of 10 pwMS died while receiving care at a hospital or another health institution, which is similar to a study from Finland published recently 20…”

Section: Discussionsupporting

confidence: 91%

“…6 Approximately, 8 out of 10 pwMS died while receiving care at a hospital or another health institution, which is similar to a study from Finland published recently. 20 The life expectancy for pwMS was, on average, reduced by 8.8 years, which is similar to the findings in a Canadian populationbased study. 21 The observed 3.9-year difference in median life expectancy between women and men with MS is comparable to the sex difference observed in the general Norwegian population.…”

Section: Discussionsupporting

confidence: 86%

“… 6 Approximately, 8 out of 10 pwMS died while receiving care at a hospital or another health institution, which is similar to a study from Finland published recently. 20 …”

Section: Discussionmentioning

confidence: 99%

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Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study

Willumsen

Grytten

Aarseth

et al. 2022

J Neurol Neurosurg Psychiatry

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BackgroundPersons with multiple sclerosis (pwMS) have higher risk of mortality compared with the general population. Longitudinal studies are important for understanding the evolution of survival in pwMS.ObjectiveExamine changes in mortality among pwMS during the past seven decades.MethodsWe followed pwMS from Hordaland and Møre and Romsdal in Western Norway, with disease onset from before 1950, identified from population-based epidemiological surveys and the Norwegian MS Registry and Biobank, until 1 January 2021. Data were linked to the Norwegian Cause of Death Registry to obtain underlying cause of death. We examined all-cause, and cause-specific mortality using standardised mortality ratios (SMR) and excess death rates (EDR). We calculated life expectancies and assessed survival stratified by sex, age and disease phenotype at onset. We compared hazard ratios (HRs) for mortality, in pwMS diagnosed before and after the era of disease-modifying treatment (DMT).ResultsOf 3624 pwMS, 964 (55.5% women) had died, predominantly of multiple sclerosis (49.0%). Median life expectancy for pwMS was 74.3 years (95% CI 73.3 to 75.3), compared with 83.1 years for the general population (p<0.001). From disease onset, pwMS survived 14.6 years shorter than the general population (p<0.001). Overall, SMR was 2.3 (95% CI 2.13 to 2.42) and EDR was 6.8 (95% CI 6.42 to 7.09) for pwMS. Treatment-eligible pwMS diagnosed in the DMT era had the lowest risk of mortality, HR 0.49 (95% CI 0.34 to 0.70,p<0.001).ConclusionExcess mortality among pwMS declined during the past seven decades, possibly due to improved diagnostics, better symptomatic treatment and access to DMTs.

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Section: Discussionsupporting

confidence: 91%