Clinical Outcome Measures Poster Presentation

P0045 - Comorbidities present before the MS diagnosis are not predictors for progression (ID 1539)

Speakers
  • M. De Vecino
Authors
  • M. De Caneda
  • C. Batista
  • M. De Vecino
Presentation Number
P0045
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Comorbidities are common in multiple sclerosis (MS) population and have been associated with the course of the disease, delays and greater disability in diagnosis, the progression of disability, higher risk of hospitalization, and shorter life expectancy. Predicting functional status and identifying potentially modifiable risk factors early in the course of the disease can help to guide the patient’s treatment.

Objectives

This study evaluated the association between the presence of comorbidities before MS diagnosis and the progression of the disease.

Methods

A retrospective cohort was performed in a reference center for MS care located in Porto Alegre – RS, Brazil. The patients were included between January 1, 2016, and December 30, 2019. A review was conducted on medical records accessing clinical and demographic data regarding age, gender, initial EDSS (EDSSi), current EDSS (EDSSc), and comorbidities before MS onset. The correlation between EDSSi, EDSSc, and the Charlston Comorbidity Index (CCI) and the Elixhauser Comorbidity Measure (ECM) was assessed.

Results

The study included 213 relapsing-remitting MS patients, 77% were females. At the time of diagnosis, 99 patients (46%) presented at least one comorbidity. Throughout the follow-up 128 patients (60%) had progression of EDSS, from whom 59 (46%) had some comorbidity prior to diagnosis, and 69 (54%) were healthy. There was no significant difference between patients with and without comorbidities in the distributions by gender (χ2 = .52; p = .46), but patients with comorbidities were significantly older (Mann-Whitney test z-score = - 3.09, p = .002). There was no significant difference between the groups in EDSSi (z-score = - 1.44, p = .14), EDSSc (z-score = - 0.02, p = .98), and in the progression of EDSS during follow-up (z-score = 0.37, p = .71). The correlation of CCI with EDSSi and EDSSc were not significant (rs = -0.02, p = 0.79 and rs= - 0.149, p = 0.14), as well as that of ECM (rs = 0.07, p = 0.45, and rs = 0.16, p = 0.10).

Conclusions

The presence of comorbidities before the MS diagnosis did not influence the disease's progression in the studied sample. The scores of the tools for measuring comorbidities have no significant association with the disability at the time of diagnosis of MS and also do not impact the worsening of EDSS. Other factors, possibly genetic and environmental, must be evaluated as causal for the progression of MS in the local population.

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