title: Risk of sepsis in patients with amyotrophic lateral sclerosis: a population-based retrospective cohort study in Taiwan.
abstract: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, and sepsis is a frequent cause of death in hospitalised patients. We investigated the relationship between ALS and the subsequent risk of sepsis.
  
  
  
  A retrospective cohort analysis.
  
  
  
  Patients with ALSs diagnosed between 2000 and 2010 in Taiwan National Health Insurance Research Database.
  
  
  
  We included 701 and 2804 patients as the ALS and the non-ALS groups, respectively.
  
  
  
  The risk of sepsis was calculated by Cox proportional hazards regression model.
  
  
  
  During the follow-up period, the incidence density rates were 77.8 and 11.1 per 1000 person-years in the ALS and non-ALS groups, respectively. After adjusting for sex, age, Charlson comorbidity index score, life-support measures, and β2-adrenoceptor agonists treatment, the ALS group had a higher risk of sepsis (HR=3.42; 95% CI 2.60 to 4.50) than the non-ALS group. An increase of the risk was observed in patients with ALS receiving life support treatment measures, whereas a decrease of the risk was associated with treatment of β2-adrenoceptor agonists.
  
  
  
  The risk of sepsis is associated with a prior ALS diagnosis, and may be increased by the use of life support measures and decreased by β2-adrenoceptor agonists.
authors.affiliation: Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: Cynthia Wei-Sheng
authors.identifier: 0000-0002-9783-8031
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: Hsuan-Ju
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D018805:Sepsis / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: amyotrophic lateral sclerosis (ALS); cohort study; life-support measures; sepsis; β2-adrenoceptor agonists