Trends in survival and cause of death in Danish patients with multiple sclerosis

Abstract

The Danish Multiple Sclerosis Registry contains information about all Danish patients in whom multiple sclerosis has been diagnosed since 1948. The purpose of this study was to analyse trends in survival and causes of death of these patients and to compare them with those of the general population. The study comprised all patients with onset in the period 1949-1996. All case records were validated and classified according to standardized diagnostic criteria. Data on emigration and death were obtained by record linkage to official registers. The end of follow-up was 1 January 2000 for emigration and death, and 1 January 1999 for cause-specific deaths. Standardized mortality ratios and excess death rates were calculated for various causes of death and periods after multiple sclerosis onset, and time trends in survival probability were analysed by Cox regression. The study comprised 9881 patients, of whom 4254 had died before end of follow-up. The median survival time from onset was approximately 10 years shorter for multiple sclerosis patients than for the age-matched general population, and multiple sclerosis was associated with an almost threefold increase in the risk for death. According to death certificates, more than half (56.4%) of the patients had died from multiple sclerosis. They also had excess mortality rates from other diseases, except cancer, and from accidents and suicide. The probability for survival improved significantly during the observation period. Thus, the 10-year excess mortality was almost halved in comparison with that in the middle of the 1900s.

Cerebral hypoperfusion in multiple sclerosis is reversible and mediated by endothelin-1

“…Some actively demyelinating lesions in MS show histological characteristics that are similar to acute white matter ischemic lesions, with a preferential loss of myelin-associated glycoprotein and apoptotic-like oligodendrocyte destruction (25,26). Epidemiological studies found that patients with MS also have a higher risk for ischemic stroke (27,28).…”

Multiple sclerosis and the role of immune cells

“…Due to many complications which occur alongside increased disability, the average life expectancy is reduced by about 5-10 years, and has a median time of 30 years between onset and death [35] . It remains to be seen whether current or future therapeutic methods may extend the time until irreversible disability occurs.…”

Cancer risk among patients with multiple sclerosis: A population‐based register study

“…2,3 Recent studies have indicated that MS incidence is increasing in several regions of the world. [3][4][5][6][7][8][9][10] Together with increased longevity of MS patients, 11 this will lead to a higher prevalence of MS worldwide, emphasizing the need for updated knowledge about comorbidity in this population.…”