title: Prevalence and risk factors of post-polio syndrome in a cohort of polio survivors.
abstract: OBJECTIVE
  To investigate frequency and associated factors of post polio syndrome (PPS) in an Italian cohort of people with prior poliomyelitis.
  
  
  METHODS
  We screened subjects admitted for poliomyelitis at the paediatric hospital of the University of Palermo during the time frame 1945-1960. Patients who developed PPS were identified through a structured questionnaire and a neurologic examination. PPS diagnosis was made according to specified diagnostic criteria. Frequency of PPS was calculated in the selected cohort of polio survivors. The association with the investigated risk factors (sex, age at onset of polio, extension and severity of polio, education, associated diseases, cigarette smoking, trauma, polio vaccination) was analysed by the calculation of the odds ratio.
  
  
  RESULTS
  Forty-eight participants met the adopted diagnostic criteria for PPS, giving a prevalence of 31.0%. The prevalence rate was significantly higher in women than in men (p=0.02). Logistic regression analyses revealed a significant inverse association with onset of poliomyelitis at over 12 months of age (OR 0.33; CI 0.14-0.79) a higher degree of education (OR 0.20; CI 0.07-0.79), and a significant association with the presence of other diseases (OR 9.86; CI 3.69-26.34).
  
  
  CONCLUSIONS
  In our survey one-third of patients with prior poliomyelitis had PPS. Higher age at onset of poliomyelitis is inversely associated with PPS. The association with other diseases may indicate that a chronic physical stress, particularly in already weak motor units, can contribute to the development of signs and symptoms of PPS. Our results also suggest the impact of socio-economic conditions on the risk of PPS.
authors: Dipartimento di Neurologia, Oftalmologia, Otorinolaringoiatria e Psichiatria, Università di Palermo, Italy.
authors: Paolo
authors: P
authors: Ragonese
authors: Brigida
authors: B
authors: Fierro
authors: Giuseppe
authors: G
authors: Salemi
authors: Giovanna
authors: G
authors: Randisi
authors: Daniela
authors: D
authors: Buffa
authors: Marco
authors: M
authors: D'Amelio
authors: Antonella
authors: A
authors: Aloisio
authors: Giovanni
authors: G
authors: Savettieri
mesh_terms: D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D011051:Poliomyelitis / Q000150:complications*; D016262:Postpoliomyelitis Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires