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Risk of sepsis in patients with amyotrophic lateral sclerosis: a population-based retrospective cohort study in
Cynthia Wei-Sheng Lee1, Hsuan-Ju Chen2, Ji-An Liang3,4
1Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Objectives:
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, and sepsis is a frequent cause of death in hospitalised patients. We investigated the relationship between ALS and the subsequent risk of sepsis.
Design:
A retrospective cohort analysis.
Setting:
Patients with ALSs diagnosed between 2000 and 2010 in Taiwan National Health Insurance Research Database.
Participants:
We included 701 and 2804 patients as the ALS and the non-ALS groups, respectively.
Outcome Measures:
The risk of sepsis was calculated by Cox proportional hazards regression model.
Results:
During the follow-up period, the incidence density rates were 77.8 and 11.1 per 1000 person-years in the ALS and non-ALS groups, respectively. After adjusting for sex, age, Charlson comorbidity index score, life-support measures, and β2-adrenoceptor agonists treatment, the ALS group had a higher risk of sepsis (HR=3.42; 95% CI 2.60 to 4.50) than the non-ALS group. An increase of the risk was observed in patients with ALS receiving life support treatment measures, whereas a decrease of the risk was associated with treatment of β2-adrenoceptor agonists.
Conclusions:
The risk of sepsis is associated with a prior ALS diagnosis, and may be increased by the use of life support measures and decreased by β2-adrenoceptor agonists.
