Is Initial Misdiagnosis Associated with Reaching Disability Milestones in Patients with Multiple Sclerosis?
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Studied Population
3.2. Impact of Misdiagnosis on Disease Progression
3.3. Symptoms at Onset as Predictors of Misdiagnosis
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Total (N = 128) | Females (N = 84) | Males (N = 44) |
---|---|---|---|
Age | 37.8 ± 10.7 | 38.7 ± 11 | 36 ± 9.7 |
Onset age | 29.7 ± 9.6 | 30.6 ± 10.2 | 27.1 ± 8.2 |
Smoking 1 | 22 (17.2%) | 10 (11.9%) | 12 (27.3%) |
Received DMT 1 | 58 (45.3%) | 40 (47.6%) | 18 (40.9%) |
BMI | 23 ± 3.8 | 22.9 ± 3.8 | 23.4 ± 3.8 |
EDSS at onset 2 | 2.5 (1.5–3) | 3.0 (1.5–3.0) | 2.0 (1.0–3.0) |
Follow-up (years) 2 | 7 (3.0–11.25) | 7 (3.0–10.25) | 8.5 (3.0–12.25) |
Reached EDSS 4 | 67 (52.3%) | 50 (59.5%) | 17 (38.6%) |
Reached EDSS 6 | 29 (22.7%) | 21 (25%) | 8 (18.2%) |
Predictors of Reaching the Milestone | HR | CI (95%) | p |
---|---|---|---|
Misdiagnosis | |||
- Not misdiagnosed (N = 75) | - | - | 1 |
- Misdiagnosed (N = 53) | 0.81 | 0.46–1.42 | 0.46 |
Sex | |||
- Female (N = 84) | - | - | 1 |
- Male (N = 44) | 0.49 | 0.26–0.92 | 0.03 |
History of smoking | |||
- No (N = 106) | - | - | 1 |
- Yes (N = 22) | 1.41 | 0.71–2.82 | 0.33 |
Age at MS onset | |||
- <18 (N = 9) | 0.44 | 0.12–1.55 | 0.2 |
- 18–50 (N = 114) | - | - | 1 |
- >50 (N = 5) | 4.01 | 1.23–13.10 | 0.02 |
BMI | |||
- <18.5 (N = 8) | 1.87 | 0.79–4.46 | 0.16 |
- 18.5–24.9 (N = 88) | - | - | 1 |
- 25–29.9 (N = 22) | 1.20 | 0.58–2.46 | 0.63 |
- ≥30 (N = 10) | 0.99 | 0.37–2.65 | 0.98 |
Age | |||
- 18–50 (N = 107) | - | - | 1 |
- >50 | 0.99 | 0.47–2.07 | 0.98 |
DMT | |||
- Did not receive DMT (N = 70) | - | - | 1 |
- Received DMT (N = 58) | 0.75 | 0.45–1.26 | 0.28 |
Predictors of Reaching the Milestone | HR | CI (95%) | p |
---|---|---|---|
Misdiagnosis | |||
- Not misdiagnosed (N = 75) | - | - | 1 |
- Misdiagnosed (N = 53) | 0.55 | 0.24–1.3 | 0.17 |
Sex | |||
- Female (N = 84) | - | - | 1 |
- Male (N = 44) | 0.87 | 0.35–2.2 | 0.77 |
History of smoking | |||
- No (N = 106) | - | - | 1 |
- Yes (N = 22) | 1.15 | 0.39–3.3 | 0.8 |
Age at MS onset | |||
- <18 (N = 9) | 0.61 | 0.07–4.9 | 0.64 |
- 18–50 (N = 114) | - | - | 1 |
- >50 (N = 5) | 2.49 | 0.39–15.8 | 0.33 |
BMI | |||
- <18.5 (N = 8) | 1.92 | 0.53–6.9 | 0.318 |
- 18.5–24.9 (N = 88) | - | - | 1 |
- 25–29.9 (N = 22) | 2.2 | 0.82–5.9 | 0.12 |
- ≥30 (N = 10) | 1.04 | 0.22–4.9 | 0.96 |
Age | |||
- 18–50 (N = 107) | - | - | 1 |
- >50 | 1.34 | 0.49–3.7 | 0.57 |
DMT | |||
- Did not receive DMT (N = 70) | - | - | 1 |
- Received DMT (N = 58) | 0.66 | 0.3–1.4 | 0.29 |
Clinical Symptoms | β | Standard Error | Wald’s χ2 | OR | CI (95%) | p |
---|---|---|---|---|---|---|
Ataxia | −1.27 | 0.58 | 4.8 | 0.28 | 0.23–0.85 | 0.03 * |
Impaired eye movements | −0.87 | 0.67 | 1.7 | 0.41 | 0.1–1.45 | 0.19 |
Optic neuritis | −0.94 | 0.51 | 3.4 | 0.38 | 0.14–1.02 | 0.06 |
Sensory loss | −0.74 | 0.46 | 2.6 | 0.48 | 0.18–1.16 | 0.11 |
Pyramidal dysfunction | 0.39 | 0.42 | 0.89 | 1.48 | 0.66–3.34 | 0.35 |
Bulbar symptoms | −1.47 | 0.88 | 2.8 | 0.23 | 0.03–1.13 | 0.09 |
Pelvic organs dysfunction | −0.79 | 0.91 | 0.75 | 0.44 | 0.17–1.88 | 0.39 |
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Ivaniuk, A.; Marusich, T.; Solodovnikova, Y.; Son, A. Is Initial Misdiagnosis Associated with Reaching Disability Milestones in Patients with Multiple Sclerosis? Medicina 2020, 56, 170. https://doi.org/10.3390/medicina56040170
Ivaniuk A, Marusich T, Solodovnikova Y, Son A. Is Initial Misdiagnosis Associated with Reaching Disability Milestones in Patients with Multiple Sclerosis? Medicina. 2020; 56(4):170. https://doi.org/10.3390/medicina56040170
Chicago/Turabian StyleIvaniuk, Alina, Tetiana Marusich, Yuliia Solodovnikova, and Anatoliy Son. 2020. "Is Initial Misdiagnosis Associated with Reaching Disability Milestones in Patients with Multiple Sclerosis?" Medicina 56, no. 4: 170. https://doi.org/10.3390/medicina56040170