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. 2019 Jun;95(1124):307-313.
doi: 10.1136/postgradmedj-2019-136667. Epub 2019 Jun 17.

Increased risk of non-multiple sclerosis demyelinating syndromes in patients with preexisting septicaemia: a nationwide retrospective cohort study

Chung-Hsing Chou  1   2 , Jiunn-Tay Lee  3   2 , Chia-Kuang Tsai  1   2 , Li-Ming Lien  4   5 , Jiu-Haw Yin  1   6 , Chun-Chieh Lin  1 , I-Ju Tsai  7 , Yueh-Feng Sung  1 , Fu-Chi Yang  1 , Chia-Lin Tsai  1 , I-Kuan Wang  8   9   10 , Chun-Hung Tseng  11 , Chung-Y Hsu  8
Affiliations

Increased risk of non-multiple sclerosis demyelinating syndromes in patients with preexisting septicaemia: a nationwide retrospective cohort study

Chung-Hsing Chou et al. Postgrad Med J. 2019 Jun.

Abstract

Background: Growing evidence shows links between septicaemia and non-multiple sclerosis demyelinating syndromes (NMSDS); nevertheless, epidemiological data are still very limited. This study aimed to explore the relationship between septicaemia and NMSDS in a general population.

Methods: The study included 482 781 individuals diagnosed with septicaemia and 1 892 825 age/sex-matched non-septicaemia patients for the comparison. Data were drawn from a population-based nationwide National Health Insurance Research Database Taiwan, from 1 January 2002 to 31 December 2011. The two cohorts of patients with and without septicaemia were followed up for the occurrence of NMSDS. The Cox-proportional hazard regression model was performed to estimate adjusted HR after multivariate adjustment.

Results: Individuals with septicaemia had a 4.17-fold (95% CI 3.21 to 5.4, p < 0.001) higher risk to develop NMSDS compared with those without septicaemia. Patients aged <65 years had a greater NMSDS risk (<45 years: HR = 6.41, 95% CI 3.65 to 11.3, p < 0.001; 45-64 years: HR = 6.66, 95% CI 3.98 to 11.2, p < 0.001). Furthermore, females with septicaemia and individuals with higher severity of septicaemia were associated with increased risks of developing NMSDS.

Conclusions: Our results indicated that patients with septicaemia were likely to develop NMSDS. A possible contributing role of septicaemia in increasing the hazard of NMSDS is proposed, based on the outcome that individuals with higher severity of septicaemia carried elevated threat of encountering NMSDS.

Keywords: acute disseminated encephalomyelitis; demyelination; septicaemia; transverse myelitis.

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Conflict of interest statement

Competing interests: No, there are no competing interests for any author.

Figures

Figure 1
Figure 1
Flowchart represents the steps of sample selection from National Health Insurance Research Database (NHIRD) Taiwan. NHI, National Health Insurance; NMSDS, non-multiple sclerosis demyelinating syndromes.
Figure 2
Figure 2
The cumulative incidence curves of non-multiple sclerosis demyelinating syndromes for individuals with and without septicaemia.
See this image and copyright information in PMC

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