Assessing the association between mortality and clinical follow-up visits in multiple sclerosis

The relationship between attendance at specialized multiple sclerosis (MS) clinics and mortality has not been fully evaluated.

We investigated the association between visits to specialized care in Danish MS clinics and mortality.

We collected data from Danish national registers to assess survival among people with MS according to the number of visits in MS clinics. We employed the Kaplan-Meier method and extended Cox regression modelling.

In total, 9929 patients with MS were included in the study, contributing 105 115 person-years at risk. A total of 316 patients with MS died during a median follow-up of 10.3 years. Cumulative visits were not statistically associated with mortality (hazard ratio (HR), 95% confidence interval (CI) = 1.00, 0.99-1.02). Female sex (0.68, 0.53-0.87), being divorced (0.56, 0.37-0.86), being married or in a partnership (0.60, 0.45-0.79) and higher education (0.64, 0.45-0.91) were independently associated with reduced mortality. Expanded Disability Status Scale (EDSS) ⩾ 3 (2.38, 1.60-3.54), ischaemic cerebrovascular disease (1.97, 1.42-2.75) and pneumonia (7.03, 5.48-9.02) were associated with an increased mortality.

We found no association between visits to specialized care and mortality. Our findings suggest that improving survival in patients with MS may require a focus on quality and content of care and proactive management of comorbidities.