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首页> 外文期刊>Journal of neurotrauma >Increased risk of multiple sclerosis after traumatic brain injury: A nationwide population-based study
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Increased risk of multiple sclerosis after traumatic brain injury: A nationwide population-based study

机译：脑外伤后多发性硬化症的风险增加：一项基于全国人群的研究

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The etiology of multiple sclerosis (MS) is still not well known. Previous data show conflicting results regarding the association between MS and prior brain trauma. This study aims to investigate the risk for MS following a traumatic brain injury (TBI) using a large-scale cohort study design. This study used data from the National Health Insurance Research Database. A total of 72,765 patients with TBI were identified and included as the study cohort, and 218,295 randomly selected subjects were matched with the study cohort by sex and age as controls. We traced each patient individually for a 6-year period from their index health care utilization to identify those who received a subsequent diagnosis of MS. We used the Kaplan-Meier method and the log-rank test to compare the difference in 6-year MS-free survival rates between the two groups. Stratified Cox proportional hazard regressions were computed to compare the risk of developing MS for these two cohorts. Patients with TBI had a higher incidence of MS during the 6-year period than the comparison group (0.055% versus 0.037%). After excluding cases who died from non-MS causes, stratifying for hospitalization of cases as a proxy for severity, and adjusting for monthly income and geographic region of the community in which the patient resided, the hazard ratio (HR) of MS for patients with hospital-treated TBI injuries was 1.97 (95% CI 1.31,2.93, p<0.01) that of patients without TBI during the 6-year follow-up period after index health care use. Our study concludes that patients with TBI are at higher risk for subsequent MS over a 6-year follow-up period.
机译：多发性硬化症（MS）的病因仍不为人所知。先前的数据显示有关MS与先前脑外伤之间关联的矛盾结果。这项研究旨在使用大规模队列研究设计来调查脑外伤（TBI）后MS的风险。这项研究使用了来自国家健康保险研究数据库的数据。确定了总共72,765例TBI患者，并将其纳入研究队列，并按性别和年龄将218,295名随机选择的受试者与研究队列匹配，作为对照组。我们从每个索引的医疗保健使用情况开始逐年追踪每位患者长达6年的时间，以识别随后接受MS诊断的患者。我们使用Kaplan-Meier方法和对数秩检验比较两组之间6年无MS生存率的差异。计算了分层Cox比例风险回归，以比较这两个队列发生MS的风险。 TBI患者在6年期间的MS发病率高于对照组（0.055％对0.037％）。在排除因非MS原因死亡的病例之后，分层进行住院治疗以评估严重程度，并根据患者所居住社区的月收入和地理区域进行调整后，MS患者的MS危险比（HR）在进行指数保健后的6年随访期内，医院治疗的TBI损伤为无TBI的患者1.97（95％CI 1.31,2.93，p <0.01）。我们的研究得出结论，在6年的随访期内，TBI患者随后发生MS的风险更高。

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