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Hospital admission due to infections in multiple sclerosis patients

Montgomery, S. and Hillert, J. and Bahmanyar, S. (2013) Hospital admission due to infections in multiple sclerosis patients. European Journal of Neurology, 20 (8). pp. 1153-1160. ISSN 13515101 (ISSN)

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Abstract

Background and purpose: Multiple sclerosis (MS) patients are at increased infection risk. Here the influences of susceptibility, severity and surveillance bias on infection-related hospital admission are assessed. Methods: Swedish registers identified 20 276 patients with MS, matched with 203 951 people from the general population without MS. Risk of first hospital admission for infection and mortality over 36 years was estimated by Poisson regression. Results: Multiple sclerosis was associated with an increased hospital admission risk for all infections, with an adjusted relative risk (and 95% confidence interval) of 4.26 (4.13-4.40). A proportion of this raised risk was probably due to surveillance and referral bias, although a raised risk remained when MS was compared with other immune-mediated diseases. The 1-month mortality rate following hospital admission for infection was higher in MS patients than in the comparison cohort, with a relative risk of 4.69 (4.21-5.22). There was no clear temporal trend in the results, and risks were higher in males and varied by MS phenotype. Conclusions: Higher hospital admission rates among MS patients for infection are likely to be due to a combination of surveillance bias, cautious medical management and greater susceptibility to severe infections. MS-related functional limitations may increase infection risk and this should be considered in MS management. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Eur. J. Neurol. [Field not mapped to EPrints] C2 - 23496086 [Field not mapped to EPrints] AD - Clinical Epidemiology and Biostatistics, �rebro University Hospital and �rebro University, �rebro, Sweden [Field not mapped to EPrints] AD - Clinical Epidemiology Unit and Centre for Pharmacoepidemiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Department of Clinical Neuroscience, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Hospital admission, Infection, Mortality, Multiple sclerosis, adult, aged, article, disease predisposition, disease severity, female, hospital admission, human, infection, infection risk, major clinical study, male, mortality, multiple sclerosis, priority journal, sex difference, hospital admission, infection, mortality, multiple sclerosis, Adult, Aged, Aged, 80 and over, Cohort Studies, Confidence Intervals, Female, Follow-Up Studies, Hospitalization, Humans, Infection, Influenza, Human, Male, Middle Aged, Multiple Sclerosis, Phenotype, Risk, Risk Factors, Sex Factors, Socioeconomic Factors, Sweden, Young Adult
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 18 Apr 2015 04:07
Last Modified: 26 Feb 2018 06:30
URI: http://eprints.goums.ac.ir/id/eprint/1846

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