title: The clinical course of multiple sclerosis patients in Hong Kong.
abstract: BACKGROUND
  Multiple sclerosis (MS) has a low prevalence in Hong Kong.
  
  
  OBJECTIVE
  To reassess MS prevalence in Hong Kong and to examine associated risk factors for relapsing-remitting type MS patients to reach Kurtzke's Extended Disability Status Scale (EDSS) of 6.0, i.e. when walking aid was needed.
  
  
  METHODS
  Retrospective observational study on MS patients over 11 years.
  
  
  METHODS
  Three tertiary hospitals in Hong Kong.
  
  
  RESULTS
  A hundred and six patients were recruited. Female to male ratio was 3.2:1 and the prevalence was 4.8 per 100,000. 95 were relapsing-remitting (RR) type. The mean disease duration was 12.7 years (range: 1-45 years) and the duration of follow up was 11.0+/-0.8 (mean+/-SE) years. The initial mean EDSS was 1.59 and the latest mean EDSS was 4.26. 38 (40%) RR type MS patients progressed to EDSS 6.0 after a mean duration of 6.0 years. With Cox regression analysis, patients with older age (>35y) of onset (HR 2.57; 95% CI:1.29-5.11), higher EDSS of 2.0 or more upon presentation (HR 2.19; 95%CI: 1.12-4.26) were associated with progression to EDSS of 6.0, while there was a tendency towards slower disease progression for patients initially presenting with optic symptoms (HR 0.52; 95%CI: 0.23-1.16). The number of relapses and use of interferon could not be shown to have significant effect on disease progression.
  
  
  CONCLUSIONS
  The local period prevalence ratio of MS was 4.8 per 100,000. Older age of onset and higher EDSS upon initial presentation were independent predictors for progression to EDSS of 6.0.
authors: Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong. dominickklau@hotmail.com
authors: Kwok-kwong
authors: KK
authors: Lau
authors: Winnie Wing-Yin
authors: WW
authors: Wong
authors: Bun
authors: B
authors: Sheng
authors: Ignatius Tak-Sun
authors: IT
authors: Yu
authors: Bun-Hey
authors: BH
authors: Fung
authors: Ho-Lun
authors: HL
authors: Li
authors: Ka-Fai Johnny
authors: KF
authors: Ma
authors: Lawrence Ka-Sing
authors: LK
authors: Wong
authors: Patrick Chung-Ki
authors: PC
authors: Li
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D004185:Disability Evaluation; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology*; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors