Multiple Sclerosis: clinical aspectsMonday, June 22, 2009, 14:45 - 15:00Pneumonia is a predictor of mortality in patients with multiple sclerosisT. Upadhyaya, P.A. Mathew, R. Potluri, A. Natalwala, H. Uppal, P. Narendran, R. Heun (Birmingham, London, UK)
Objective: Multiple sclerosis is a chronic disabling neurological illness. Pneumonia has been proven to have a significant association in patients with multiple sclerosis compared with the background population. This study investigated if pneumonia is a predictor of in multiple sclerosis.
Methods: During 2000-2007, 1152 patients with multiple sclerosis were admitted to a large general hospital in Birmingham. Multiple sclerosis cases and co-morbidities were traced using the ICD-10 criteria. Predictors of in-hospital mortality were determined using the Cox regression model.
Results: Of the 1152 patients with multiple sclerosis, 98 patients died during the time period. The predictors of mortality in multiple sclerosis were shown to be age (p<0.001), pneumonia (p<0.001). The relative risk of mortality in patients with pneumonia and multiple sclerosis was 6.28 (95% C.I; 3.38-11.6).
Conclusion: Pneumonia has been found to be the only predictor of mortality in multiple sclerosis. This is a new finding, with research so far identifying a link between a pneumonia causing a relapse in patients with multiple sclerosis but not as a predictor of in-hospital mortality. Therefore, clinical practice should focus on prevention, anticipation and low thresholds for treatment of pneumonia amongst patients with multiple sclerosis.
|