Long-term disability in multiple sclerosis: a longitudinal study over 20 years

Year 2023, Volume: 48 Issue: 3, 965 - 971, 30.09.2023

Sena Destan Bünül

https://doi.org/10.17826/cumj.1335021

Abstract

Purpose: This study investigated the long-term clinical and demographic characteristics of multiple sclerosis (MS) patients to predict disease prognosis.
Materials and Methods: Two hundred and seventy-five MS patients diagnosed using the Poser or McDonald criteria were retrospectively analyzed. They were categorized based on their Expanded Disability Status Scale (EDSS) scores: below 4 (group 1) and 4 or above (group 2).
Results: The average patient age was 55.45 ± 9.63 years, with a disease duration of 26.76 ± 6.08 years. The initial EDSS scores increased from 2.56 ± 2.36 to 4.23 ± 1.8 after 20 years. Of the patients, 69.1% had EDSS scores of 4 or higher after 20 years. Notably, patients with supratentorial and spinal cord involvement at onset had higher EDSS scores. Logistic regression analysis revealed that a higher initial EDSS score, no full recovery after the first attack, and a longer duration between attacks were associated with a higher risk of an EDSS score of 4 or above.
Conclusion: Thisr study shows that an increase in the initial EDSS score is predictive of long-term disability in patients with MS. Having information on long-term, real-life data in MS is highly valuable in terms of understanding the course of the disease, its monitoring, and treatment selection.

Keywords

multiple sclerosis, disability, long term

Multipl sklerozda uzun dönem yeti yitimi: 20 yıllık uzunlamasına bir çalışma

Abstract

Amaç: Bu çalışma, hastalık prognozunu tahmin etmek için Multipl Skleroz (MS) hastalarının uzun vadeli klinik ve demografik özelliklerini araştırmaktadır.
Gereç ve Yöntem: Poser veya McDonald kriterleri kullanılarak teşhis konulan 275 MS hastası retrospektif olarak incelendi. Genişletilmiş Engellilik Durumu Ölçeği (EDSS) puanlarına göre 4'ün altı (grup 1) ile 4 ve 4'ün üzerinde (grup 2) olarak sınıflandırıldı.
Bulgular: Hastaların ortalama yaşı 55.459.63, hastalık süresi 26.766.08 yıldı. İlk EDSS puanları 20 yıl sonra 2.56 ± 2.36'dan 4.23 ± 1.8'e yükselmiştir. %69,1'inin 20 yıl sonra EDSS puanı 4 veya daha yüksekti. Özellikle, supratentoryal ve omurilik tutulumu başlangıçlı hastalar daha yüksek EDSS skorları gösterdi. Lojistik regresyon analizi, daha yüksek bir ilk EDSS puanının, ilk ataktan sonra tam iyileşme olmamasının ve ataklar arasında daha uzun bir sürenin, 4 veya daha yüksek bir EDSS puanı riski ile ilişkili olduğunu ortaya koydu.
Sonuç: Çalışmamız, başlangıçtaki EDSS'deki artışın MS'te uzun süreli sakatlığın öngörücüsü olduğunu desteklemektedir. MS'te uzun dönemli gerçek yaşam verileri hakkında bilgi sahibi olmak, hastalığın seyrini anlamak, takibi ve tedavi seçimi açısından oldukça değerlidir.

Keywords

Multipl skleroz, yeti yitimi, prognoz

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