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Survival and cause of death in multiple sclerosis: results from a 50-year follow-up in Western Norway

¹ Department of Neurology, The Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Section for Neurology, University of Bergen, Bergen, Norway
² Department of Health, University Research Bergen, Bergen, Norway
³ Department of Neurology, The Norwegian MS Registry, Haukeland University Hospital, Bergen, Norway
⁴ Department of Clinical Medicine, Section for Neurology, University of Bergen, Bergen, Norway

^* To whom correspondence should be addressed.

	Abstract

Background

Survival time among patients with multiple sclerosis (MS) has varied considerably according to previous reports.

Objectives

Survival and cause of death were analyzed among all patients with MS (878) with onset of MS in Hordaland County, Western Norway during 1953–2003, of whom 198 were dead at follow-up on January 1, 2005.

Methods

Standardized mortality ratios (SMRs) and relative mortality ratios (RMRs) were calculated based on observed mortality in MS and expected mortality.

Results

Median survival from onset was 41 years versus 49 years in the corresponding population, and mortality (SMR) was 2.7-fold increased in MS. The median survival was 43 years among women and 36 years among men, but women had higher relative mortality, when compared with the corresponding population, than men (RMR = 1.40). The median survival time was 45 years among young-onset patients (21–30 years) and 23 years among older-onset patients (51–60 years), but young-onset patients had higher relative mortality than older-onset patients, as shown by a significant reduction by 10-year interval of age at onset (RMR = 0.65). Median survival from onset was longer (43 years) among relapsing–remitting MS than primary progressive MS ([PPMS]; 49 years), and the relative mortality was higher in the PPMS group, (RMR = 1.55). According to death certificates, 57% died from MS.

Conclusion

Female patients and patients with young onset had longer median time to death but higher relative risk of dying compared with the corresponding population. PPMS had both shorter median time to death from onset and a higher relative risk of dying.

Key Words: cancer-related mortality, corresponding population, multiple sclerosis survival, relative mortality ratio

First published on July 16, 2008, doi:10.1177/1352458508093890

Multiple Sclerosis 2008;14:1191.

A more recent version of this article appeared on November 1, 2008


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