Survival in multiple sclerosis correlates to the level of hygiene and mortality
Wojciech Cendrowski
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Introduction: Survival of patients with multiple sclerosis is a complex variable determined by several factors. Objective of the study was to ascertain the association between the level of hygiene well as regional mortality and survival of patients with multiple sclerosis. Study design: The study of relation between variables included 14,200 multiple sclerosis patients (male – 6,025, female – 8,175) who died in the period 1981–2010 in Poland. The average survival of male and female patients with multiple sclerosis correlated to the marker of hygiene level (the late mortality in infants rate per 1,000 live births) and average, annual, sex-adjusted mortality rates for multiple sclerosis in towns and in the countryside of Poland (1981–2010). All demographic data were obtained from the Central Statistical Office in Warsaw. Results: A longer survival of male and female patients with multiple sclerosis showed a significant correlation to a higher hygiene level in Poland: r = −0.867, r = −0.902, p = 0.0001. Sex-adjusted mortality rates for women with multiple sclerosis in towns and villages were much higher than the analogous rates for men with multiple sclerosis; p = 0.0001, p = 0.019. A longer duration of life in male and female patients with multiple sclerosis demonstrated a strong, inverse correlation to a lower mortality in the countryside: r = −0.803, r = −0.630, p = 0.0001. The survival of women with multiple sclerosis did not show correlation to sex-adjusted mortality rates in towns: r = −0.126, p = 0.90. Conclusions: The higher level of hygiene was associated with the longer survival of multiple sclerosis patients. The survival of male and female patients with multiple sclerosis showed an inverse correlation to the lower mortality in rural regions. The duration of life in women did not correlate to the higher mortality in towns.