Contributions
Abstract: 144
Type: Free Communications
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Multiple sclerosis (MS) is associated with chronic disability and reduced life expectancy. In recent years therapeutic opportunities to modify the disease course have expanded, and it has become important to gain a better understanding of the causes of mortality. Multiple-cause-of-death data have been used successfully to investigate the complex patterns of death causes that are associated with chronic diseases. Our goal was to assess the associations between MS and all other causes listed on the death certificates for the population of decedents in British Columbia, Canada.
Methods: Multiple-cause-of-death data, which include the underlying and all contributing causes of death, were accessed for all adult (aged >18) deaths in British Columbia occurring between 1986 and 2013. The International Classification of Disease codes, as listed on the certificate, were classified into 'underlying' or 'any mention' grouped causes. Logistic regression was used to examine the association between mention of MS on the death certificate and mention of each of the grouped causes, with adjustment for age, sex and calendar year of death.
Results: There were 771,288 deaths over the 37-year period; the mean age at death was 74.5 years (SD: 16.0) and 47.5% were women. MS was mentioned as a cause for 2,153 (0.28%) deaths, but more commonly listed as the underlying cause for younger deaths (< 40 years; 78%) than for deaths at an older age (>80 years; 49%). If MS was mentioned (versus not mentioned) there was a greater chance that the following conditions contributed to the death: urinary tract infections (adjusted odds ratio [aOR]: 10.2, 95% CI: 8.7-12.0), aspiration pneumonia (aOR: 7.15, 95% CI: 6.23-8.22), skin disease (aOR: 5.06, 95% CI: 3.96-6.46), respiratory infection (aOR: 3.03, 95% CI: 2.73-3.36), non-infectious respiratory disease (aOR: 1.65, 95% CI: 1.49-1.83), and other infections and sepsis (aOR: 1.34, 95% CI: 1.15-1.56).
Conclusions: Deaths that were due to MS were commonly caused by infections and conditions that are complications of severe disability. Interventions aimed at reducing the frequency and severity of these complications would be expected to improve survival in MS.
Disclosure: This study was funded by research grants from the Canadian Institutes of Health Research (MOP-82738;PI: Tremlett) and the USA's National MS Society (RG:5064-A-5; PI: Tremlett).
The authors have no specific disclosures with regards to this study.
Dr Harding was funded by a MS Society of Canada fellowship and has received research support from Novartis for work that is unrelated to this study.
Mr Zhu has nothing to disclose.
Dr Alotaibi was funded by a MITACS Globalink Research Internship Award.
Mr Duggan has nothing to disclose.
Helen Tremlett is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis and in the last 3 years has received research support from: the MS Society of Canada, the MS Scientific and Research Foundation, the US National Multiple Sclerosis Society; the Canadian Institutes of Health Research, the Canada Foundation for Innovation and the UK MS Trust.
Dr Kingwell is funded through operating grants from the Canadian Institutes of Health Research, the USA's National MS Society and the MS Society of Canada.
Abstract: 144
Type: Free Communications
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Multiple sclerosis (MS) is associated with chronic disability and reduced life expectancy. In recent years therapeutic opportunities to modify the disease course have expanded, and it has become important to gain a better understanding of the causes of mortality. Multiple-cause-of-death data have been used successfully to investigate the complex patterns of death causes that are associated with chronic diseases. Our goal was to assess the associations between MS and all other causes listed on the death certificates for the population of decedents in British Columbia, Canada.
Methods: Multiple-cause-of-death data, which include the underlying and all contributing causes of death, were accessed for all adult (aged >18) deaths in British Columbia occurring between 1986 and 2013. The International Classification of Disease codes, as listed on the certificate, were classified into 'underlying' or 'any mention' grouped causes. Logistic regression was used to examine the association between mention of MS on the death certificate and mention of each of the grouped causes, with adjustment for age, sex and calendar year of death.
Results: There were 771,288 deaths over the 37-year period; the mean age at death was 74.5 years (SD: 16.0) and 47.5% were women. MS was mentioned as a cause for 2,153 (0.28%) deaths, but more commonly listed as the underlying cause for younger deaths (< 40 years; 78%) than for deaths at an older age (>80 years; 49%). If MS was mentioned (versus not mentioned) there was a greater chance that the following conditions contributed to the death: urinary tract infections (adjusted odds ratio [aOR]: 10.2, 95% CI: 8.7-12.0), aspiration pneumonia (aOR: 7.15, 95% CI: 6.23-8.22), skin disease (aOR: 5.06, 95% CI: 3.96-6.46), respiratory infection (aOR: 3.03, 95% CI: 2.73-3.36), non-infectious respiratory disease (aOR: 1.65, 95% CI: 1.49-1.83), and other infections and sepsis (aOR: 1.34, 95% CI: 1.15-1.56).
Conclusions: Deaths that were due to MS were commonly caused by infections and conditions that are complications of severe disability. Interventions aimed at reducing the frequency and severity of these complications would be expected to improve survival in MS.
Disclosure: This study was funded by research grants from the Canadian Institutes of Health Research (MOP-82738;PI: Tremlett) and the USA's National MS Society (RG:5064-A-5; PI: Tremlett).
The authors have no specific disclosures with regards to this study.
Dr Harding was funded by a MS Society of Canada fellowship and has received research support from Novartis for work that is unrelated to this study.
Mr Zhu has nothing to disclose.
Dr Alotaibi was funded by a MITACS Globalink Research Internship Award.
Mr Duggan has nothing to disclose.
Helen Tremlett is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis and in the last 3 years has received research support from: the MS Society of Canada, the MS Scientific and Research Foundation, the US National Multiple Sclerosis Society; the Canadian Institutes of Health Research, the Canada Foundation for Innovation and the UK MS Trust.
Dr Kingwell is funded through operating grants from the Canadian Institutes of Health Research, the USA's National MS Society and the MS Society of Canada.