| Title: |
Influence of socio-economic status on excess mortality of multiple sclerosis |
| Authors: |
Wilson, Sharon, A.; Calocer, F.; Rollot, F.; Fauvernier, M.; Remontet, L; Tron, L; Leray, Emmanuelle; Dejardin, Olivier; Defer, G. |
| Contributors: |
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE); Université de Caen Normandie (UNICAEN); Normandie Université (NU)-Normandie Université (NU)-CHU Caen; Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse Caen (UNICANCER/CRLC); Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM); CHU Caen; Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN); Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE); Université de Lyon-Université de Lyon-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS); Arènes: politique, santé publique, environnement, médias (ARENES); Université de Rennes (UR)-Institut d'Études Politiques IEP - Rennes-École des Hautes Études en Santé Publique EHESP (EHESP)-Université de Rennes 2 (UR2)-Centre National de la Recherche Scientifique (CNRS); École des Hautes Études en Santé Publique EHESP (EHESP); Département Méthodes quantitatives en santé publique (METIS); Recherche sur les services et le management en santé (RSMS); Université de Rennes (UR)-École des Hautes Études en Santé Publique EHESP (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); ARSEP foundation "Fondation pour l'aide a la recherche sur la Sclerose en Plaques"; ANR-10-COHO-0002,OFSEP,Observatoire Français de la Sclérose en Plaques(2010) |
| Source: |
ISSN: 1352-4585. |
| Publisher Information: |
HAL CCSD; SAGE Publications |
| Publication Year: |
2023 |
| Collection: |
Université de Rennes 1: Publications scientifiques (HAL) |
| Subject Terms: |
Multiple sclerosis; Excess mortality; Net survival; Socio-economic status; Flexible model; Observational cohort study; [SDV]Life Sciences [q-bio] |
| Description: |
International audience ; BackgroundThe effects of socio-economic status on mortality in patients with multiple sclerosis is not well known. The objective was to examine mortality due to multiple sclerosis according to socio-economic status.MethodsA retrospective observational cohort design was used with recruitment from 18 French multiple sclerosis expert centers participating in the Observatoire Français de la Sclérose en Plaques. All patients lived in metropolitan France and had a definite or probable diagnosis of multiple sclerosis according to either Poser or McDonald criteria with an onset of disease between 1960 and 2015. Initial phenotype was either relapsing-onset or primary progressive onset. Vital status was updated on January 1st 2016. Socio-economic status was measured by an ecological index, the European Deprivation Index and was attributed to each patient according to their home address. Excess death rates were studied according to socio-economic status using additive excess hazard models with multidimensional penalised splines. The initial hypothesis was a potential socio-economic gradient in excess mortality.FindingsA total of 34,169 multiple sclerosis patients were included (88% relapsing onset (n = 30,083), 12% progressive onset (n = 4086)), female/male sex ratio 2.7 for relapsing-onset and 1.3 for progressive-onset). Mean age at disease onset was 31.6 (SD = 9.8) for relapsing-onset and 42.7 (SD = 10.8) for progressive-onset. At the end of follow-up, 1849 patients had died (4.4% for relapsing-onset (n = 1311) and 13.2% for progressive-onset (n = 538)). A socio-economic gradient was found for relapsing-onset patients; more deprived patients had a greater excess death rate. At thirty years of disease duration and a year of onset of symptoms of 1980, survival probability difference (or deprivation gap) between less deprived relapsing-onset patients (EDI = −6) and more deprived relapsing-onset patients (EDI = 12) was 16.6% (95% confidence interval (CI) [10.3%–22.9%]) for men and 12.3% (95%CI ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Availability: |
https://hal.science/hal-03925229 |
| Rights: |
http://creativecommons.org/licenses/by-nc/ |
| Accession Number: |
edsbas.7920B003 |
| Database: |
BASE |