Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Clinical characterization of delayed alcohol-induced headache: A study of 1,108 participants

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Evaluation of inflammatory lesions over 2 years in facioscapulohumeral muscular dystrophy

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Permanent muscle weakness in hypokalemic periodic paralysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Intrarater reliability and validity of outcome measures in myotonic dystrophy type 1

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Accuracy of a machine learning muscle MRI-based tool for the diagnosis of muscular dystrophies

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Klinisk Neurologi og Neurokirurgi

    Research output: Book/ReportBookEducation

  2. Author response: Nationwide prevalence and incidence study of neuromyelitis optica spectrum disorder in Denmark

    Research output: Contribution to journalComment/debateResearchpeer-review

  3. Alcohol consumption in adolescence is associated with a lower risk of multiple sclerosis in a Danish cohort

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVE: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS.

METHODS: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005. To investigate the time of diagnosis, we compared individuals with and without chronic comorbidity using multinomial logistic regression. To investigate mortality, we used Cox regression with time-dependent covariates, following study participants from clinical MS onset until endpoint (death) or to the end of the study, censuring at emigration.

RESULTS: We identified 8,947 individuals with clinical onset of MS between 1980 and 2005. In the study of time of diagnosis, we found statistically significant odds ratios for longer diagnostic delays with cerebrovascular comorbidity (2.01 [1.44-2.80]; <0.0005), cardiovascular comorbidity (4.04 [2.78-5.87]; <0.0005), lung comorbidity (1.93 [1.42-2.62]; <0.0005), diabetes comorbidity (1.78 [1.04-3.06]; 0.035), and cancer comorbidity (2.10 [1.20-3.67]; 0.009). In the mortality study, we found higher hazard ratios with psychiatric comorbidity (2.42 [1.67-3.01]; <0.0005), cerebrovascular comorbidity (2.47 [2.05-2.79]; <0.0005), cardiovascular comorbidity (1.68 [1.39-2.03]; <0.0005), lung comorbidity (1.23 [1.01-1.50]; 0.036), diabetes comorbidity (1.39 [1.05-1.85]; 0.021), cancer comorbidity (3.51 [2.94-4.19]; <0.0005), and Parkinson disease comorbidity (2.85 [1.34-6.06]; 0.007).

CONCLUSIONS: An increased awareness of both the necessity of neurologic evaluation of new neurologic symptoms in persons with preexisting chronic disease and of optimum treatment of comorbidity in MS is critical.

Original languageEnglish
JournalNeurology
Volume89
Issue number16
Pages (from-to)1668-1675
Number of pages8
ISSN0028-3878
DOIs
Publication statusPublished - 17 Oct 2017

    Research areas

  • Adult, Autoimmune Diseases, Cardiovascular Diseases, Cerebrovascular Disorders, Cohort Studies, Community Health Planning, Comorbidity, Delayed Diagnosis, Denmark, Female, Humans, Kidney Diseases, Logistic Models, Male, Middle Aged, Mood Disorders, Multiple Sclerosis, Neoplasms, Neurologic Examination, Parkinson Disease, Time Factors, Young Adult, Journal Article

ID: 52217822