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Disability and Survival of Multiple Sclerosis in Saskatoon, Saskatchewan

Published online by Cambridge University Press:  02 December 2014

Walter J. Hader
Walter J. Hader*
Affiliation:
Department of Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon City Hospital, Saskatoon, Saskatchewan, Canada
*
University of Saskatchewan, Department of Physical Medicine and Rehabilitation, 701 Queen Street, Saskatoon City Hospital, Saskatoon, Saskatchewan, S7K 0M7, Canada.
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Abstract

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Background:

A population-based prevalent group of 150 clinical definite patients ascertained on 1 January 1977, in Saskatoon, Saskatchewan, was followed for 30 years.

Objectives:

To outline the clinical characteristics, determine the levels of disability at 15, 25, 35, 40, and 45 years after onset, to estimate the survival after onset and life expectancy.

Methods:

Clinical records were maintained, and the cohort reviewed each decade for 30 years. The disability levels according to the Kurtzke Extended Disability Status Scale were recorded and survival times were estimated. SPSS and Kaplan-Meier methods were used for analysis.

Results:

On prevalence day, 1 January 1977, there were 48(32%) men and 102(68%) women, with an average age of onset of 32.2±10 years and 28.4±8.6 years. The average duration of disease was 15.7 years. On 1 January 2007, 39(26%) patients were living, 105(70%) deceased, and 6(4%) were missing The disability levels recorded in 1977 and 2007, at 15 and 45 years after onset, were mild (EDSS≤2.5), 33.3% and 8.0%; moderate (EDSS3-5.5), 17.3% and 2.7%; severe (EDSS6-7.5), 6.6% and 4.7%; maximum (EDSS8-9.5), 22.7% and 10.7%. The median survival time after onset was 33 (95% CI: 27.3-38.6) years for men and 38 (95% CI: 34.1-41.9) years for women. The median duration of life was 68.9 years for men and 69.5 years for women, and a decreased life expectancy of 7.7 and 12.8 years.

Conclusions:

Multiple sclerosis is a progressive neurological disorder and long-term survival is associated with moderate to severe disability and decreased life expectancy.

Résumé:

RÉSUMÉ:Contexte:

Un groupe de 150 patients atteints de sclérose en plaques (SP) certaine, identifiés le premier janvier 1977 à Saskatoon en Saskatchewan, a été suivi pendant 30 ans.

Objectifs:

Le but de l'étude était de définir les caractéristiques cliniques, de déterminer les niveaux d'invalidité 15, 25, 35,40 et 45 ans après le début de la maladie, d'estimer la survie après le début de la maladie et l'espérance de vie.

Méthodes:

Les dossiers cliniques ont été mis à jour et la cohorte a été révisée à chaque décennie pendant 30 ans. Les niveaux d'invalidité selon la Kurtzke Extended Disability Status Scale (EDSS) ont été notés et le temps de survie a été estimé. Les données ont été analysées par SPSS et analyse de Kaplan-Meier.

Résultats:

Le premier janvier 1977, le jour où la prévalence a été déterminée, la cohorte était constituée de 48 hommes (32%) et de 102 femmes (68%) dont l'âge de début moyen était de 32,2 ± 10 ans et 28,4 ± 8,6 ans respectivement. La durée moyenne de la maladie était de 15,7 ans. Le premier janvier 2007, 39 patients (26%) étaient toujours vivants, 105 (70%) étaient décédés et 6 (4%) avaient été perdus de vue. Les niveaux d'invalidité notés en 1977 et en 2007, soit 15 et 45 ans après le début de la maladie, étaient légers (EDSS < 2,5) chez 33,3% et 8,0%; modérés (EDSS 3 à 5,5), chez 17,3% et 2,7%; sévères (EDSS 6 à 7,5) chez 6,6% et 4,7%; maximaux (EDSS 8 à 9,5) chez 22,7% et 10,7% respectivement. La survie médiane après le début de la maladie était de 33 ans (IC à 95% de 27,3 à 38,6) chez les hommes et de 38 ans (IC à 95% de 34,1 à 41,9) chez les femmes. La durée médiane de vie était de 68,9 ans chez les hommes et de 69,5 ans chez les femmes et l'espérance de vie était diminuée de 7,7 et 12,8 ans respectivement.

Conclusions:

La SP est une maladie neurologique progressive et la survie à long terme est associée à une invalidité de modérée à sévère et à une espérance de vie réduite.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 1 , January 2010 , pp. 28 - 35
Copyright
Copyright © The Canadian Journal of Neurological 2010

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