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Increased risk of non-multiple sclerosis demyelinating syndromes in patients with preexisting septicaemia: a nationwide retrospective cohort study

Authors
  • Chou, Chung-Hsing1, 2
  • Lee, Jiunn-Tay1, 2
  • Tsai, Chia-Kuang1, 2
  • Lien, Li-Ming3, 4
  • Yin, Jiu-Haw1, 5
  • Lin, Chun-Chieh1
  • Tsai, I-Ju6
  • Sung, Yueh-Feng1
  • Yang, Fu-Chi1
  • Tsai, Chia-Lin1
  • Wang, I-Kuan7, 6, 8
  • Tseng, Chun-Hung8
  • Hsu, Chung-Y7
  • 1 Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China , Taipei
  • 2 Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China , Taipei
  • 3 Shin-Kong WHS Memorial Hospital, Taipei, Taiwan, Republic of China , Taipei
  • 4 School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China , Taipei
  • 5 Cheng Hsin General Hospital, Taipei, Taiwan, Republic of China , Taipei
  • 6 College of Medicine, China Medical University, Taichung, Taiwan, Republic of China , Taichung
  • 7 Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, Republic of China , Taichung
  • 8 China Medical University Hospital, Taichung, Taiwan, Republic of China , Taichung
Type
Published Article
Journal
Postgraduate Medical Journal
Publisher
BMJ
Publication Date
Jun 17, 2019
Volume
95
Issue
1124
Pages
307–313
Identifiers
DOI: 10.1136/postgradmedj-2019-136667
PMID: 31209183
PMCID: PMC6613738
Source
PubMed Central
Keywords
License
Green

Abstract

Background Growing evidence shows links between septicaemia and non-multiple sclerosis demyelinating syndromes (NMSDS); nevertheless, epidemiological data are still very limited. This study aimed to explore the relationship between septicaemia and NMSDS in a general population. Methods The study included 482 781 individuals diagnosed with septicaemia and 1 892 825 age/sex-matched non-septicaemia patients for the comparison. Data were drawn from a population-based nationwide National Health Insurance Research Database Taiwan, from 1 January 2002 to 31 December 2011. The two cohorts of patients with and without septicaemia were followed up for the occurrence of NMSDS. The Cox-proportional hazard regression model was performed to estimate adjusted HR after multivariate adjustment. Results Individuals with septicaemia had a 4.17-fold (95% CI 3.21 to 5.4, p < 0.001) higher risk to develop NMSDS compared with those without septicaemia. Patients aged <65 years had a greater NMSDS risk (<45 years: HR = 6.41, 95% CI 3.65 to 11.3, p < 0.001; 45–64 years: HR = 6.66, 95% CI 3.98 to 11.2, p < 0.001). Furthermore, females with septicaemia and individuals with higher severity of septicaemia were associated with increased risks of developing NMSDS. Conclusions Our results indicated that patients with septicaemia were likely to develop NMSDS. A possible contributing role of septicaemia in increasing the hazard of NMSDS is proposed, based on the outcome that individuals with higher severity of septicaemia carried elevated threat of encountering NMSDS.

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