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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Standardized mortality ratios in multiple sclerosis: Systematic review with meta-analysis.

Natasha Smyrke1, Nicky Dunn2,3, Chantelle Murley4

  • 1School of Medicine and Surgery, University of Auckland, Auckland, New Zealand.

Acta Neurologica Scandinavica
|November 25, 2021
PubMed
Summary

People with multiple sclerosis (MS) have significantly reduced survival rates and an increased risk of death from various causes, including cardiovascular and respiratory diseases. These mortality trends for MS patients have remained consistent over the past 65 years.

Keywords:
meta-analysismortalitymultiple sclerosisstandardized mortalitysystematic review

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Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease with significant impact on patient survival.
  • Understanding mortality patterns in MS is crucial for public health initiatives and patient care.

Purpose of the Study:

  • To conduct a meta-analysis of mortality data for individuals with multiple sclerosis.
  • To determine all-cause, cause-specific, and gender-specific standardized mortality ratios (SMR) and crude mortality rates (CMR).
  • To analyze temporal trends in mortality among people with MS.

Main Methods:

  • A systematic literature search was performed using Medline, Cochrane Library, and Scopus.
  • Included studies provided data on deaths, follow-up duration, person-years, and SMR for multiple sclerosis patients.
  • Crude mortality rates were calculated, and SMRs were extracted; meta-regression analyzed temporal trends.

Main Results:

  • Fifteen studies encompassing 160,000 patients and 21,225 deaths (1949-2013) were analyzed.
  • The overall standardized mortality ratio (SMR) for MS was 2.61, with similar rates for men (2.47) and women (2.57).
  • Increased mortality risk was observed for cardiovascular disease (SMR 1.74), respiratory disease and infection (SMR 4.70), and accidents/suicide (SMR 1.81), but not cancer (SMR 0.99).

Conclusions:

  • Individuals with multiple sclerosis experience reduced overall survival.
  • There is an elevated risk of mortality from cardiovascular diseases, respiratory conditions, infections, accidents, and suicide in the MS population.
  • No significant temporal changes in these mortality trends were observed over the study period.