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Cause of death in patients attending multiple sclerosis clinics
A D Sadovnick1, K Eisen, G C Ebers
1Multiple Sclerosis Clinic, University Hospital-UBC Site, Vancouver, Canada.
Insights
Patients with Multiple Sclerosis (MS) have a significantly higher risk of suicide compared to the general population. MS complications were the leading cause of death, but suicide risk warrants attention.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease.
- Understanding mortality patterns in MS patients is crucial for clinical care and public health initiatives.
Purpose of the Study:
- To investigate the causes of death among patients with Multiple Sclerosis (MS).
- To compare mortality rates and causes of death in MS patients with the general population.
Main Methods:
- Retrospective analysis of mortality data from MS clinics in Vancouver and London.
- Determining the exact cause of death for 145 MS patients between 1972 and 1988.
- Comparing cause-specific mortality proportions to age-matched general population data.
Main Results:
- Complications of MS accounted for 47.1% of deaths.
- Suicide risk was 7.5 times higher in MS patients compared to the general population.
- Malignancy and stroke mortality rates were similar to the general population, while myocardial infarction was slightly elevated.
Conclusions:
- While MS complications are the primary cause of death, suicide represents a significant and elevated risk factor.
- Further research into mental health support for MS patients is warranted.
- Mortality patterns for malignancy and stroke do not differ significantly from the general population.
Abstract:
Between 1972 and 1988, 145 deaths occurred among 3,126 patients attending the Multiple Sclerosis (MS) Clinics in Vancouver, British Columbia (N = 1,583), and London, Ontario (N = 1,543). We could determine the exact cause of death in 82.1% of cases (119 of 145). Of the 119 patients for whom the cause of death was known, 56 deaths (47.1%) were directly attributed to complications of MS. Of the remaining 63 deaths, 18 (28.6%) were suicides, 19 (30.2%) were due to malignancy, 13 (20.6%) to an acute myocardial infarction, seven (11.1%) to stroke, and the remainder (9.5%) to miscellaneous causes, of which two may have been suicides. The proportion of suicides among MS deaths was 7.5 times that for the age-matched general population, and the proportion of MS deaths from malignancy was 0.67 times that for the age-matched general population. The proportion of deaths due to malignancy and stroke was the same for the MS patients and the age-matched general population.