The association between septicemia and the risk of multiple sclerosis: A nationwide register-based retrospective cohort study in Taiwan

C. L. Tsai, J. T. Lee, L. M. Lien, C. C. Lin, I. J. Tsai, Y. F. Sung, C. H. Chou, F. C. Yang, C. L. Tsai, I. K. Wang, C. H. Tseng, C. Y. Hsu

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Abstract

Background: Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system. Few studies focused on the relationship between septicemia and MS. Aim: To evaluate the potential impact of septicemia on risk for MS. Design: Two cohorts of patients with septicemia and without septicemia were followed up for the occurrence of MS. Methods: Patients of 482 790 with septicemia was enrolled from the National Health Insurance Research Database between 2001 and 2011 as the study group to match the 1 892 820 individuals, as the control group, by age and gender. Incidence of MS in both groups was calculated. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR) for MS between groups. Results: Septicemia patients had a 3.06-fold (95% CI: 2.16-4.32, P < 0.001) greater risk of developing MS than the matched group. In addition, higher severity of septicemia was associated with higher risk of developing MS (moderate: HR ¼ 4.03, 95% CI: 2.53-6.45, P < 0.001; severe: HR ¼ 11.1, 95% CI: 7.01-17.7, P < 0.001). Similar results also occurred in both male and female patients with septicemia (male: HR ¼ 4.06, 95% CI: 2.17-7.58, P < 0.001; female: HR ¼ 2.72, 95% CI: 1.79-4.11, P < 0.001). Patients without counterpart comorbidities had a significantly higher risk of MS than the controlled group (HR ¼ 3.02, 95% CI: 2.10-4.35, P < 0.001). Conclusion: The results indicated septicemia is linked to an increased risk for MS. Aggressively preventing and treating septicemia may be warranted for one of precautionary strategies of MS.

Original languageEnglish
Pages (from-to)605-611
Number of pages7
JournalQJM
Volume111
Issue number9
DOIs
Publication statusPublished - Jan 1 2018

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Taiwan
Multiple Sclerosis
Sepsis
Cohort Studies
Retrospective Studies
National Health Programs
Demyelinating Diseases
Comorbidity
Research Design
Central Nervous System
Databases
Control Groups
Incidence

ASJC Scopus subject areas

  • Medicine(all)

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The association between septicemia and the risk of multiple sclerosis : A nationwide register-based retrospective cohort study in Taiwan. / Tsai, C. L.; Lee, J. T.; Lien, L. M.; Lin, C. C.; Tsai, I. J.; Sung, Y. F.; Chou, C. H.; Yang, F. C.; Tsai, C. L.; Wang, I. K.; Tseng, C. H.; Hsu, C. Y.

In: QJM, Vol. 111, No. 9, 01.01.2018, p. 605-611.

Research output: Contribution to journalArticle

Tsai, CL, Lee, JT, Lien, LM, Lin, CC, Tsai, IJ, Sung, YF, Chou, CH, Yang, FC, Tsai, CL, Wang, IK, Tseng, CH & Hsu, CY 2018, 'The association between septicemia and the risk of multiple sclerosis: A nationwide register-based retrospective cohort study in Taiwan', QJM, vol. 111, no. 9, pp. 605-611. https://doi.org/10.1093/qjmed/hcy123
Tsai, C. L. ; Lee, J. T. ; Lien, L. M. ; Lin, C. C. ; Tsai, I. J. ; Sung, Y. F. ; Chou, C. H. ; Yang, F. C. ; Tsai, C. L. ; Wang, I. K. ; Tseng, C. H. ; Hsu, C. Y. / The association between septicemia and the risk of multiple sclerosis : A nationwide register-based retrospective cohort study in Taiwan. In: QJM. 2018 ; Vol. 111, No. 9. pp. 605-611.
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title = "The association between septicemia and the risk of multiple sclerosis: A nationwide register-based retrospective cohort study in Taiwan",
abstract = "Background: Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system. Few studies focused on the relationship between septicemia and MS. Aim: To evaluate the potential impact of septicemia on risk for MS. Design: Two cohorts of patients with septicemia and without septicemia were followed up for the occurrence of MS. Methods: Patients of 482 790 with septicemia was enrolled from the National Health Insurance Research Database between 2001 and 2011 as the study group to match the 1 892 820 individuals, as the control group, by age and gender. Incidence of MS in both groups was calculated. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR) for MS between groups. Results: Septicemia patients had a 3.06-fold (95{\%} CI: 2.16-4.32, P < 0.001) greater risk of developing MS than the matched group. In addition, higher severity of septicemia was associated with higher risk of developing MS (moderate: HR ¼ 4.03, 95{\%} CI: 2.53-6.45, P < 0.001; severe: HR ¼ 11.1, 95{\%} CI: 7.01-17.7, P < 0.001). Similar results also occurred in both male and female patients with septicemia (male: HR ¼ 4.06, 95{\%} CI: 2.17-7.58, P < 0.001; female: HR ¼ 2.72, 95{\%} CI: 1.79-4.11, P < 0.001). Patients without counterpart comorbidities had a significantly higher risk of MS than the controlled group (HR ¼ 3.02, 95{\%} CI: 2.10-4.35, P < 0.001). Conclusion: The results indicated septicemia is linked to an increased risk for MS. Aggressively preventing and treating septicemia may be warranted for one of precautionary strategies of MS.",
author = "Tsai, {C. L.} and Lee, {J. T.} and Lien, {L. M.} and Lin, {C. C.} and Tsai, {I. J.} and Sung, {Y. F.} and Chou, {C. H.} and Yang, {F. C.} and Tsai, {C. L.} and Wang, {I. K.} and Tseng, {C. H.} and Hsu, {C. Y.}",
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TY - JOUR

T1 - The association between septicemia and the risk of multiple sclerosis

T2 - A nationwide register-based retrospective cohort study in Taiwan

AU - Tsai, C. L.

AU - Lee, J. T.

AU - Lien, L. M.

AU - Lin, C. C.

AU - Tsai, I. J.

AU - Sung, Y. F.

AU - Chou, C. H.

AU - Yang, F. C.

AU - Tsai, C. L.

AU - Wang, I. K.

AU - Tseng, C. H.

AU - Hsu, C. Y.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system. Few studies focused on the relationship between septicemia and MS. Aim: To evaluate the potential impact of septicemia on risk for MS. Design: Two cohorts of patients with septicemia and without septicemia were followed up for the occurrence of MS. Methods: Patients of 482 790 with septicemia was enrolled from the National Health Insurance Research Database between 2001 and 2011 as the study group to match the 1 892 820 individuals, as the control group, by age and gender. Incidence of MS in both groups was calculated. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR) for MS between groups. Results: Septicemia patients had a 3.06-fold (95% CI: 2.16-4.32, P < 0.001) greater risk of developing MS than the matched group. In addition, higher severity of septicemia was associated with higher risk of developing MS (moderate: HR ¼ 4.03, 95% CI: 2.53-6.45, P < 0.001; severe: HR ¼ 11.1, 95% CI: 7.01-17.7, P < 0.001). Similar results also occurred in both male and female patients with septicemia (male: HR ¼ 4.06, 95% CI: 2.17-7.58, P < 0.001; female: HR ¼ 2.72, 95% CI: 1.79-4.11, P < 0.001). Patients without counterpart comorbidities had a significantly higher risk of MS than the controlled group (HR ¼ 3.02, 95% CI: 2.10-4.35, P < 0.001). Conclusion: The results indicated septicemia is linked to an increased risk for MS. Aggressively preventing and treating septicemia may be warranted for one of precautionary strategies of MS.

AB - Background: Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system. Few studies focused on the relationship between septicemia and MS. Aim: To evaluate the potential impact of septicemia on risk for MS. Design: Two cohorts of patients with septicemia and without septicemia were followed up for the occurrence of MS. Methods: Patients of 482 790 with septicemia was enrolled from the National Health Insurance Research Database between 2001 and 2011 as the study group to match the 1 892 820 individuals, as the control group, by age and gender. Incidence of MS in both groups was calculated. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR) for MS between groups. Results: Septicemia patients had a 3.06-fold (95% CI: 2.16-4.32, P < 0.001) greater risk of developing MS than the matched group. In addition, higher severity of septicemia was associated with higher risk of developing MS (moderate: HR ¼ 4.03, 95% CI: 2.53-6.45, P < 0.001; severe: HR ¼ 11.1, 95% CI: 7.01-17.7, P < 0.001). Similar results also occurred in both male and female patients with septicemia (male: HR ¼ 4.06, 95% CI: 2.17-7.58, P < 0.001; female: HR ¼ 2.72, 95% CI: 1.79-4.11, P < 0.001). Patients without counterpart comorbidities had a significantly higher risk of MS than the controlled group (HR ¼ 3.02, 95% CI: 2.10-4.35, P < 0.001). Conclusion: The results indicated septicemia is linked to an increased risk for MS. Aggressively preventing and treating septicemia may be warranted for one of precautionary strategies of MS.

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