[A multivariate analysis of prognostic factors of spinocerebellar degenerations]

To clarify the factors relating to the prognosis of spinocerebellar degenerations (SCD), we performed a follow-up study on the survival of patients with Friedreich disease, familial spastic paraparasis, sporadic olivopontocerebellar atrophy (OPCA), hereditary OPCA of Menzel type, sporadic late cortical cerebellar atrophy (LCCA), cerebellar atrophy of Holmes type, Shy-Drager syndrome, striatonigral degeneration, dentatorubropallidoluysian atrophy, or Joseph disease. One hundred and forty-eight patients admitted to the Nagoya University Hospital during the period of 1976 to 1990 were dealt with. They had been followed-up for 15 years at longest through the medical records, or through the direct informations from the patients or their family members or both. In order to find factors influencing the survival of the patients, Kaplan-Meier method was used as the 1st step to construct the survival curve for each factor. These were calculated by generalized Wilcoxon test. Employing Cox's proportional hazard model, a multivariate analysis was then performed based on the factors which were shown significant in the 1st step. The multivariate analysis showed that the following four factors are related to the prognosis of SCD patients, i.e., lack of hereditary trait, existence of orthostatic hypotension, lack of walking disorder at onset, and lack of nystagmus on admission. Of these factors, the lack of hereditary trait had the most intimate relation to their poor prognosis. Therefore, these four factors are statistically informative to predict prognosis of each patient with SCD.