title: Disability and mortality in a cohort of multiple sclerosis patients: a reappraisal.
abstract: The aim of the study was to evaluate how the natural history of multiple sclerosis (MS) had changed over a 15-year period. We compared disability and mortality in a cohort of 83 MS patients hospitalised in the Neurological Institute of Pavia, northern Italy, from January 1, 1990, to December 31, 1991, with a similar cohort of 52 patients analysed in the past. After the follow-up, an unfavourable course (death or relevant disability) was observed in 41% of the patients in the new cohort, compared to 63.5% of the patients in the old one. The percentage of deceased patients was reduced from 25 to 6%. The analysis of the pooled data of the two cohorts indicates a recent tendency of firstly hospitalised patients having a shorter disease duration and a lower disability level, which could explain the relevant decrease both in mortality and disability. Finally, our findings confirmed that age at onset, early disability and a short interval between onset and secondary progression increase the risk of an unfavourable course.
authors.affiliation: Multiple Sclerosis Centre, Department of Clinical Neurology, Neurological Institute 'C. Mondino', Pavia, Italy. roberto.bergamaschi@mondino.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Bergamaschi
authors.forename: Cristina
authors.initials: C
authors.lastname: Montomoli
authors.forename: Elisa
authors.initials: E
authors.lastname: Candeloro
authors.forename: Cesare
authors.initials: C
authors.lastname: Fratti
authors.forename: Antonietta
authors.initials: A
authors.lastname: Citterio
authors.forename: Vittorio
authors.initials: V
authors.lastname: Cosi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors