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Prognostic factors for survival in multiple sclerosis

Z M Levi

Institute of Neurology, School of Medicine, University of Belgrade, Dr Subotia 6, Belgrade 11 000, Yugoslavia

I Dujmovi

Institute of Neurology, School of Medicine, University of Belgrade, Dr Subotia 6, Belgrade 11 000, Yugoslavia

T Pekmezovi

Institute of Epidemiology, School of Medicine, University of Belgrade, Viegradska 26a, Belgrade 11 000, Yugoslavia

M Jarebinski

Institute of Epidemiology, School of Medicine, University of Belgrade, Viegradska 26a, Belgrade 11 000, Yugoslavia

J Marinkovi

Institute of Biostatistics, Public Health and Research in Medicine, School of Medicine, University of Belgrade, Dr Subotia 15, Belgrade 11 000, Yugoslavia

N Stojsavljevi

Institute of Neurology, School of Medicine, University of Belgrade, Dr Subotia 6, Belgrade 11 000, Yugoslavia

J Drulovi

Institute of Neurology, School of Medicine, University of Belgrade, Dr Subotia 6, Belgrade 11 000, Yugoslavia

In a hospital-based study of 119 patients with definite multiple sclerosis, demographic and clinical factors were analysed with respect to their validity in assessing the long-term prognosis. Over a mean follow-up of 21.7 years, the following factors negatively influenced the prognosis by the univariate analysis: male sex, age at onset over 25, pyramidal involvement or spasticity at onset, 53 functional systems affected at onset or after 5 years, incomplete first remission, length of the first remission 41 year, 45 attacks in the first 10 years, secondary or primary-progressive disease, time to reach secondary progression over 5 years and time to reach EDSS 6 over 7 years. The multivariate model showed that in patients with relapsing-remitting disease, 5 years after onset, pyramidal involvement at onset and shorter time to reach EDSS 6 predicted poor outcome, while after 10 years, higher age at onset and incomplete first remission indicated poor prognosis. Ten years after onset, the predictors of poor outcome in the secondary-progressive group were shorter time to reach EDSS 6 or secondary progression and higher EDSS, while in the primary-progressive group those variables were spasticity or higher number of functional systems affected at onset, and higher EDSS after 5 and 10 years.

Key Words: multiple sclerosis • course • prognosis • survival analysis • multivariate analysis • clinical features • demographic features

Multiple Sclerosis, Vol. 5, No. 3, 171-178 (1999)
DOI: 10.1177/135245859900500306


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