Health care use preceding pediatric multiple sclerosis: A population-based study from Ontario, Canada.

IF 5 2区医学 Q1 CLINICAL NEUROLOGY

Multiple Sclerosis Journal Pub Date : 2025-05-23 DOI:10.1177/13524585251338745

Ruth Ann Marrie, Colleen J Maxwell, Karl Everett, Feng Zhu, Ping Li, Kyla A McKay, Yinshan Zhao, Helen Tremlett

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引用次数: 0

Abstract

Background: Investigations of a prodrome in multiple sclerosis (MS) usually have included adults.

Objective: To compare rates and reasons for health care use in youth with and without MS, considering time relative to the MS index date and to birth.

Methods: This retrospective cohort study used population-based administrative data (1991-2020) from Ontario, Canada. We matched youth (<18 years) with MS up to 5:1 to youth without MS by sex, birth year, region, and duration of observation (full cohorts). Subcohorts had data from birth to MS index date (first demyelinating disease claim). We compared health services use, adjusting for age, sex, area-level income, region, and year.

Results: We included 451 individuals with pediatric-onset MS and 1422 without MS. As of 6 years pre-index, the full MS cohort had higher physician services use (year 6: rate ratio (RR) = 1.45; 95% confidence interval (95% CI) = 1.25-1.67) and hospitalizations (RR = 2.79; 95% CI = 1.31-5.94). Findings were similar in subcohorts. The MS subcohort had elevated physician visit rates in early life that rose as the MS index date approached.

Discussion: Youth with pediatric-onset MS exhibit increased health care use from birth. Early life may be a risk period for MS. A prodromal phase may emerge 6 years before the onset of typical MS symptoms.

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儿童多发性硬化症前的医疗保健使用：一项来自加拿大安大略省的基于人群的研究。

背景：多发性硬化症（MS）前驱症状的调查通常包括成人。目的：比较青年多发性硬化症和非多发性硬化症的发生率和原因，考虑与多发性硬化症指数日期和出生时间相关的时间。方法：这项回顾性队列研究使用了来自加拿大安大略省的基于人口的行政数据（1991-2020）。我们匹配了年轻人（结果：我们纳入了451名儿科发病多发性硬化症患者和1422名非多发性硬化症患者）。在指数前6年，整个多发性硬化症队列有更高的医生服务使用率(第6年：比率(RR) = 1.45；95%可信区间(95% CI) = 1.25-1.67)和住院率(RR = 2.79；95% ci = 1.31-5.94)。亚群研究结果相似。随着MS指数日期的临近，MS亚队列的早期医生就诊率升高。讨论：患有儿科发病多发性硬化症的青少年从出生起就表现出越来越多的医疗保健使用。生命早期可能是多发性硬化症的危险期，前驱期可能在典型多发性硬化症症状出现前6年出现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple Sclerosis Journal 医学-临床神经学

CiteScore

10.90

自引率

6.90%

发文量

186

审稿时长

3-8 weeks

期刊介绍： Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system. The journal for your research in the following areas: * __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics * __Epidemology and genetics:__ genetics epigenetics, epidemiology * __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures * __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management Print ISSN: 1352-4585