Factores asociados con el tiempo de progresión de la discapacidad en pacientes con esclerosis múltiple

Anibal Arteaga-Noriega; John Fredy Castro-Álvarez; Dione Benjumea-Bedoya; Johanna Gutiérrez-Vargas; Angela Segura-Cardona; Difariney González-Gómez; José Zapata-Berruecos

doi:10.17843/rpmesp.2022.394.11433

Authors

Anibal Arteaga-Noriega Grupo de Investigación en Epidemiología y Bioestadística, Universidad CES, Medellín, Colombia; Grupo de Investigación en Salud Familiar y Comunitaria, Corporación Universitaria Remington, Medellín, Colombia. https://orcid.org/0000-0002-6612-1169
John Fredy Castro-Álvarez Grupo de Investigación en Neurociencias y Envejecimiento, Corporación Universitaria Remington, Medellín, Colombia. https://orcid.org/0000-0002-9049-0271
Dione Benjumea-Bedoya Grupo de Investigación en Salud Familiar y Comunitaria, Corporación Universitaria Remington, Medellín, Colombia. https://orcid.org/0000-0002-4004-2219
Johanna Gutiérrez-Vargas Grupo de Investigación en Neurociencias y Envejecimiento, Corporación Universitaria Remington, Medellín, Colombia. https://orcid.org/0000-0002-9875-8789
Angela Segura-Cardona Grupo de Investigación en Epidemiología y Bioestadística, Universidad CES, Medellín, Colombia. https://orcid.org/0000-0002-0010-1413
Difariney González-Gómez Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia. https://orcid.org/0000-0002-0175-2613
José Zapata-Berruecos Grupo de Investigación en Epidemiología y Bioestadística, Universidad CES, Medellín, Colombia; Instituto Neurológico de Colombia, Medellín, Colombia. https://orcid.org/0000-0002-3493-2872

DOI:

https://doi.org/10.17843/rpmesp.2022.394.11433

Keywords:

multiple sclerosis, Multivariate Analysis, disability evaluations

Abstract

Objectives. To determine the sociodemographic, clinical and radiological factors associated with time to disability progression in patients with multiple sclerosis (MS). Materials and methods. Cross-sectional descriptive study with an analytical component, based on clinical records of patients at the Neurological Institute of Colombia, between 2013 and 2021. Progression to disability in MS patients was defined as the time to an increase of at least 0.5 points in the EDSS (Expanded Disability Status Scale) score, sustained
for at least six months. A Cox regression model was used to estimate the survival function and Hazard Ratios (HR) with their 95% confidence intervals (95% CI). Results. We included 216 patients, of whom 25% progressed to disability, median survival was 78 months (95% CI: 70-83), active lesions (HR = 1.94; 95% CI: 1.10-3.44), cerebellar complications (HR = 2.03; 95% CI: 0. 99-4.16), being male (HR = 2.5; 95% CI: 1.32-4.73), and having neurological diseases (HR = 2.18; 95% CI: 1.03-4.61) were associated as risk factors. While relapsing remitting MS (HR = 0.63; 95% CI: 0.31-1.26) and age at diagnosis less than 40
years (HR = 0.96; 95% CI: 0.53-1.76) were associated as protective factors. Conclusions. Progression is affected by many factors, and there is no single independent factor.

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