Number of visits to MS clinics not tied to mortality risk in disease
Danish study finds being female or married links to higher survival rate
A person’s total number of visits to multiple sclerosis (MS) clinics is not associated with a lower risk of death, suggesting that merely increasing the number of clinical follow-up visits is not enough to improve survival, a new study in Denmark found.
Instead, factors such as being female, having higher education levels, or being married were independently associated with reduced mortality, while a higher disability level and having had a stroke or pneumonia significantly reduced survival.
The findings suggest that improving care, proactively managing occurring conditions, and addressing social factors such as education level may be more effective for improving survival in people with MS.
“Our findings suggest that improving survival in patients with MS may require a focus on quality and content of care, as well as proactive management of comorbidities, rather than increasing visit frequency,” researchers wrote. The study also underscores “the need to address social determinants alongside clinical care.”
The study, “Assessing the association between mortality and clinical follow-up visits in multiple sclerosis,” was published in the Multiple Sclerosis Journal.
Women had lower risk of death then men
A number of factors can impact survival rates in MS. In other health conditions, limited use of healthcare services has been linked to poorer disease control and shorter survival. However, it’s been unclear whether this is also the case for people living with MS.
To learn more, researchers in Denmark analyzed survival data from 9,929 adults with MS who were diagnosed between 2000 and 2020 and followed through the Danish MS Registry.
About two-thirds of participants were women, and three-quarters had relapsing-remitting MS. Their median age at diagnosis was 39 years, and the median disability score was 2, indicating mild disease.
After a median follow-up of 10.3 years, 316 patients died. The overall mortality rate was 3 per 1,000 person-years, a measure that accounts for the number of years that each patient was followed, with the group having a 91% survival probability.
Overall, our findings suggest that while specialized care remains essential for the management of MS, the number of visits alone does not appear to reduce mortality.
A number of factors were found to influence survival, but no significant association was observed between the number of visits to specialized MS clinics and the risk of death.
Instead, a statistical analysis accounting for multiple factors showed women had a 32% lower risk of death than men, being divorced or married was linked to a 40% and 44% lower risk of death, respectively, compared with being single, and higher education was associated with a 36% lower risk than lower education.
In turn, a person’s mortality risk increased by more than twofold if a person had moderate disability, or a score of three or more on the Expanded Disability Status Scale (EDSS), versus an EDSS score of 2. Co-occurring conditions like stroke and pneumonia also increased the risk of death by approximately twofold and sevenfold, respectively.
“Overall, our findings suggest that while specialized care remains essential for the management of MS, the number of visits alone does not appear to reduce mortality,” the researchers wrote. “Focused efforts on quality of care, prevention, and management of comorbidities, and early treatment initiation may be more impactful targets for improving survival outcomes in patients with MS.”
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