Abstract Details

Title Subcategory Analysis of Causes of Death in Patients with Multiple Sclerosis from a Large US Insurance Database

Topic MS and Related Diseases

Presentation(s) S30 - (-)

Poster/Presentation
Number 007

Objective

Background Information on causes of death (CODs) for patients with MS is sparse and hampered by inherent limitations in standard categorization on death certificates of underlying and immediate CODs. Prior research comparing patients with MS and non-MS matched comparators in a US health plan database (OptumInsight Research [OIR]) using an algorithm designed to assess causes leading to death (CLD), indicated that excess mortality rates (MR) among patients with MS were largely due to higher MR from infectious, cardiovascular, or pulmonary causes.

Design/Methods Patients with MS enrolled in OIR (1996-2009) were matched to non-MS comparators on age/residence at index year and sex. CLDs were determined using an algorithm that reduced the rate at which MS or cardiac/pulmonary arrest were selected as the COD. CLDs were categorized into MS, cancer, cardiovascular, infectious, suicide, accidental, pulmonary, other, or unknown. Infectious, cardiovascular, and pulmonary CODs were further subcategorized.

Results 31,051 patients with MS were matched to 92,511 controls, with MR of 899 and 446 deaths/100,000 person-years, respectively. 90.6% of the excess mortality related to infectious CODs was attributable to pulmonary infections (41 of 95 [43.2%] excess deaths per 100,000 person-years) or sepsis (45 of 95 [47.4%] excess deaths per 100,000 person-years). 58.7% of the difference in MR attributable to pulmonary CODs was due to aspiration (27 of 46 excess deaths per 100,000 person-years). No single diagnostic entity predominated for the 60 deaths per 100,000 person-years excess mortality attributable to cardiac CODs.

Conclusions Fatal pulmonary infections, sepsis, and aspiration occurred more frequently in patients with MS than non-MS comparators. Increased awareness of the potential for death due to these causes may improve care for patients with MS.

Authors/Disclosures
Stefanie Snow (Precept) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Gary R. Cutter, PhD (University of Alabama At Birmingham)	Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biodelivery Sciences International, Biogen, Click Therapeutics, Genzyme, Genentech, GW Pharmaceuticals, Immunic, Klein-Buendel Incorporated, Medimmune/Viela Bio, Medday, Merck/Serono, Neurogenesis LTD, Novartis, Osmotica Pharmaceuticals, Perception Neurosciences, Recursion/Cerexis Pharmaceuticals, Regeneron, Reckover Pharmaceuticals, Roche, TG Therapeutics.. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Applied Therapeutics, AI therapeutics, AMO Pharma, Astra-Zeneca, Avexis Pharmaceuticals, Biolinerx, Brainstorm Cell Therapeutics, Bristol Meyers Squibb/Celgene, CSL Behring, Galmed Pharmaceuticals, Green Valley Pharma, Horizon Pharmaceuticals, Immunic, Karuna Therapeutics, Mapi Pharmaceuticals LTD, Merck, Mitsubishi Tanabe Pharma Holdings, Opko Biologics,Prothena Biosciences, Novartis, Regeneron, Sanofi-Aventis, Reata Pharmaceuticals, NHLBI (Protocol Review Committee), University of Texas Southwestern, University of Pennsylvania, Visioneering Technologies, Inc.. Dr. Cutter has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JASN.
Jurgen Koehler	No disclosure on file
	No disclosure on file
Dirk Pleimes, MD (Bayer Healthcare)	No disclosure on file
Douglas S. Goodin, MD (Univ of Calif at San Francisco)	No disclosure on file

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