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Factors impacting mortality rates in a large French Canadian MS population: a review of 4 decades of data

Rousseau, Marie-Claude; Richard, Hugues; Conus, Florence; Roger, Elaine; Despault, Pierre; Duquette, Pierre (2017). Factors impacting mortality rates in a large French Canadian MS population: a review of 4 decades of data In: 7th Joint European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS)-Americas-Committee-for-Treatment-and-Research-in-Multiple-Scle rosis (ACTRIMS), October 25-28, 2017, Paris, France.

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Résumé

Background: Several studies have concluded that the lifespan of a person with multiple sclerosis (MS) is 6 years less than that of the general population. However these studies did not reflect the latest advancements in disease-modifying therapies. Little is known about the impact of factors such as gender, disease course, date of onset by decades, or age at onset on longevity.

Methods: The Montreal-based CHUM MS Clinic was established in 1975. Since its inception, cohorts of 3771 patients have been followed and, in April 2016, their vital status was obtained through the provincial health care system database. Mortality rates, per 1000 person-years, were estimated according to gender, disease course at baseline, and age at onset. Follow-ups were carried out from the first clinic visit until death, or up to April 2016.

Results: This cohort consists of 3771 patients with a median follow-up of 13.7 years, representing 55,339 person-years. A total of 482 (13%) patients were deceased at the end of the follow-up period. The overall mortality rate was 8.7 per 1000 person-years. The mortality rate was higher among men (11.6 per 1000 person-years) than women (7.6 per 1000 person-years). Disease course at baseline greatly influenced mortality. Mortality rates were 5.5 among patients who had a persistent clinically isolated syndrome (n=750), 7.2 among those with a relapsing course (n=2465), 18.2 among those with secondary progressive (n=127) and 19.1 per 1000 person-years among patients with primary progressive course (n=429). In a subgroup of subjects who started their follow-up at the clinic within a maximum of 3 years after onset, age at onset was strongly related to mortality. Mortality rates were 2.9, 4.3, and 11.6 per 1000 person-years respectively among patients who were ≤20, 20-40, and >40 years at onset.

Discussion: Our observed results are in agreement with those published from similar cohorts in Canada and in Europe. Striking differences in mortality rates were observed according to gender, disease course at baseline, and age at onset. As the lifespan of the MS population increases, so does the need for global strategies for the care of aging MS patients.

Conclusion: This work is a first step in a study on the impact of aging in MS. Further work will be conducted on other factors that may impact mortality such as comorbidities, lifestyle, and treatment.

Type de document: Document issu d'une conférence ou d'un atelier
Informations complémentaires: Affiche scientifique P341 Multiple Sclerosis Journal 2017; 23: (suppl. 3) 123-124 https://doi.org/10.1177/1352458517731404
Mots-clés libres: -
Centre: Centre INRS-Institut Armand Frappier
Date de dépôt: 25 mars 2019 20:25
Dernière modification: 25 mars 2019 20:25
URI: http://espace.inrs.ca/id/eprint/6745

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