Disability and mortality in a cohort of multiple sclerosis patients: a reappraisal.
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.
Bergamaschi
Roberto
R
Multiple Sclerosis Centre, Department of Clinical Neurology, Neurological Institute 'C. Mondino', Pavia, Italy. roberto.bergamaschi@mondino.it
Montomoli
Cristina
C
Candeloro
Elisa
E
Fratti
Cesare
C
Citterio
Antonietta
A
Cosi
Vittorio
V
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