Factors associated with the progression of disability (EDSS) among MS patients

Multiple sclerosis is a chronic, inflammatory, autoimmune disease of the central nervous system. Accumulating neurological disability has a substantial impact on the lives of patients with MS. The Expanded Disability Status Scale is a method of quantifying disability in MS.

The aim of this study was to analyze the disability trajectory across years of patients living with MS seen at the Neurological Institute and to explore factors associated with the rate of change per year.

A single-center study was conducted at the Neurological Institute located in the city of Medellin based on medical records obtained from 2013 to 2021. The clinical and demographic characteristics were analyzed using descriptive statistics. To recognize changes in the rate of increase in disability measured by the EDSS with increasing time lived with the disease, a polynomial model was used.

Disability measured by the EDSS was not linear over time, there were times when disability progressed more rapidly and other times when it was slower. The bivariate model showed that variables such as gait medications and botulinum toxin had the highest beta values; however, the multivariate model showed that clinical and sociodemographic variables such as initial cerebellar symptoms and sex had the highest significant beta values.

This type of study facilitates predictions of natural history within the risk scheme. Prognostic models for chronic diseases are needed to guide management decisions and counseling of patients and their families. Such models can consider outcomes ranging from response to treatment to changes in disability.