Defining high, medium and low impact prognostic factors for developing multiple sclerosis

摘要: Natural history studies have identified factors that predict evolution to multiple sclerosis or risk of disability accumulation over time. Although these are based on large multicentre cohorts with long follow-ups, they limitations such as lack standardized protocols, a retrospective data collection systematic magnetic resonance imaging acquisition and analysis protocol, often resulting in failure take oligoclonal bands into account joint covariates the prediction models. To overcome some limitations, aim our study was identify stratify baseline demographic, clinical, radiological biological characteristics might development using multivariate approach prospective cohort patients clinically isolated syndromes. From 1995 2013, 1058 syndromes were included. We evaluated influence prognostic for developing definite sclerosis, McDonald (Expanded Disability Status Scale score 3.0) univariate (hazard ratio 95% confidence intervals) (adjusted hazard Cox regression ultimately included 1015 followed mean 81 (standard deviation = 57) months. Female/male 2.1. Females exhibited similar conversion compared males. Each younger decade at onset associated greater protective effect disability. Patients optic neuritis had lower [hazard 0.6 (0.5-0.8)] progression 0.5 (0.3-0.8)]; however, this remained marginal only [adjusted (0.4-1.0)] adjusted The presence increased 1.3 (1.0-1.8)] 2.0 (1.2-3.6)] independently other factors. 10 more brain lesions 11.3 (6.7-19.3)] 2.9 (1.4-6.0)]. Disease-modifying treatment before second attack reduced (0.4-0.9)] (0.3-0.9)]. conclude demographic topographic low-impact factors, is medium-impact factor, number high-impact factor.