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agate
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Joined: 17 May 2006
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Location: Oregon
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 Posted: Tue Apr 02, 2013 5:59 pm Post subject: (AAN) Causes of death in PwMS ... |
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Presented at the AAN conference in San Diego, March 16-23, 2013:
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[S30.007] Subcategory Analysis of Causes of Death in Patients with Multiple Sclerosis from a Large US Insurance Database
Michael Corwin, Waltham, MA, Shoshana Reshef, Montville, NJ, Howard Golub, Waltham, MA, Gary Cutter, Birmingham, AL, David Kaufman, Boston, MA, Dirk Pleimes, Pine Brook, NJ, Douglas Goodin, San Francisco, CA
OBJECTIVE:
To analyze subcategories within disease categories to gain more insight into pathways more directly leading to death in patients with multiple sclerosis (MS).
BACKGROUND:
Information on causes of death (CODs) for patients with MS is sparse and hampered by inherent limitations in standard categorization on death certificates of underlying and immediate CODs. Prior research comparing patients with MS and non-MS matched comparators in a US health plan database (OptumInsight Research [OIR]) using an algorithm designed to assess causes leading to death (CLD), indicated that excess mortality rates (MR) among patients with MS were largely due to higher MR from infectious, cardiovascular, or pulmonary causes.
DESIGN/METHODS:
Patients with MS enrolled in OIR (1996-2009) were matched to non-MS comparators on age/residence at index year and sex. CLDs were determined using an algorithm that reduced the rate at which MS or cardiac/pulmonary arrest were selected as the COD. CLDs were categorized into MS, cancer, cardiovascular, infectious, suicide, accidental, pulmonary, other, or unknown. Infectious, cardiovascular, and pulmonary CODs were further subcategorized.
RESULTS:
31,051 patients with MS were matched to 92,511 controls, with MR of 899 and 446 deaths/100,000 person-years, respectively.
90.6% of the excess mortality related to infectious CODs was attributable to pulmonary infections (41 of 95 [43.2%] excess deaths per 100,000 person-years) or sepsis (45 of 95 [47.4%] excess deaths per 100,000 person-years).
58.7% of the difference in MR attributable to pulmonary CODs was due to aspiration (27 of 46 excess deaths per 100,000 person-years).
No single diagnostic entity predominated for the 60 deaths per 100,000 person-years excess mortality attributable to cardiac CODs.
CONCLUSIONS:
Fatal pulmonary infections, sepsis, and aspiration occurred more frequently in patients with MS than non-MS comparators. Increased awareness of the potential for death due to these causes may improve care for patients with MS.
__________________________
Supported by:
Bayer HealthCare Pharmaceuticals.
Category - MS and Related Diseases: Clinical Science
Session S30: Multiple Sclerosis: Treatment Safety |
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