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Abstract：
UNASSIGNED: The effects of socio-economic status on mortality in patients with multiple sclerosis is not well known. The objective was to examine mortality due to multiple sclerosis according to socio-economic status.
UNASSIGNED: A retrospective observational cohort design was used with recruitment from 18 French multiple sclerosis expert centers participating in the Observatoire Français de la Sclérose en Plaques. All patients lived in metropolitan France and had a definite or probable diagnosis of multiple sclerosis according to either Poser or McDonald criteria with an onset of disease between 1960 and 2015. Initial phenotype was either relapsing-onset or primary progressive onset. Vital status was updated on January 1st 2016. Socio-economic status was measured by an ecological index, the European Deprivation Index and was attributed to each patient according to their home address. Excess death rates were studied according to socio-economic status using additive excess hazard models with multidimensional penalised splines. The initial hypothesis was a potential socio-economic gradient in excess mortality.
UNASSIGNED: A total of 34,169 multiple sclerosis patients were included (88% relapsing onset (n = 30,083), 12% progressive onset (n = 4086)), female/male sex ratio 2.7 for relapsing-onset and 1.3 for progressive-onset). Mean age at disease onset was 31.6 (SD = 9.8) for relapsing-onset and 42.7 (SD = 10.8) for progressive-onset. At the end of follow-up, 1849 patients had died (4.4% for relapsing-onset (n = 1311) and 13.2% for progressive-onset (n = 538)). A socio-economic gradient was found for relapsing-onset patients; more deprived patients had a greater excess death rate. At thirty years of disease duration and a year of onset of symptoms of 1980, survival probability difference (or deprivation gap) between less deprived relapsing-onset patients (EDI = -6) and more deprived relapsing-onset patients (EDI = 12) was 16.6% (95% confidence interval (CI) [10.3%-22.9%]) for men and 12.3% (95%CI [7.6%-17.0%]) for women. No clear socio-economic mortality gradient was found in progressive-onset patients.
UNASSIGNED: Socio-economic status was associated with mortality due to multiple sclerosis in relapsing-onset patients. Improvements in overall care of more socio-economically deprived patients with multiple sclerosis could help reduce these socio-economic inequalities in multiple sclerosis-related mortality.
UNASSIGNED: This study was funded by the ARSEP foundation \"Fondation pour l\'aide à la recherche sur la Sclérose en Plaques\" (Grant Reference Number 1122). Data collection has been supported by a grant provided by the French State and handled by the \"Agence Nationale de la Recherche,\" within the framework of the \"Investments for the Future\" programme, under the reference ANR-10-COHO-002, Observatoire Français de la Sclérose en Plaques (OFSEP).
UNASSIGNED: A retrospective observational cohort design was used with recruitment from 18 French multiple sclerosis expert centers participating in the Observatoire Français de la Sclérose en Plaques. All patients lived in metropolitan France and had a definite or probable diagnosis of multiple sclerosis according to either Poser or McDonald criteria with an onset of disease between 1960 and 2015. Initial phenotype was either relapsing-onset or primary progressive onset. Vital status was updated on January 1st 2016. Socio-economic status was measured by an ecological index, the European Deprivation Index and was attributed to each patient according to their home address. Excess death rates were studied according to socio-economic status using additive excess hazard models with multidimensional penalised splines. The initial hypothesis was a potential socio-economic gradient in excess mortality.
UNASSIGNED: A total of 34,169 multiple sclerosis patients were included (88% relapsing onset (n = 30,083), 12% progressive onset (n = 4086)), female/male sex ratio 2.7 for relapsing-onset and 1.3 for progressive-onset). Mean age at disease onset was 31.6 (SD = 9.8) for relapsing-onset and 42.7 (SD = 10.8) for progressive-onset. At the end of follow-up, 1849 patients had died (4.4% for relapsing-onset (n = 1311) and 13.2% for progressive-onset (n = 538)). A socio-economic gradient was found for relapsing-onset patients; more deprived patients had a greater excess death rate. At thirty years of disease duration and a year of onset of symptoms of 1980, survival probability difference (or deprivation gap) between less deprived relapsing-onset patients (EDI = -6) and more deprived relapsing-onset patients (EDI = 12) was 16.6% (95% confidence interval (CI) [10.3%-22.9%]) for men and 12.3% (95%CI [7.6%-17.0%]) for women. No clear socio-economic mortality gradient was found in progressive-onset patients.
UNASSIGNED: Socio-economic status was associated with mortality due to multiple sclerosis in relapsing-onset patients. Improvements in overall care of more socio-economically deprived patients with multiple sclerosis could help reduce these socio-economic inequalities in multiple sclerosis-related mortality.
UNASSIGNED: This study was funded by the ARSEP foundation \"Fondation pour l\'aide à la recherche sur la Sclérose en Plaques\" (Grant Reference Number 1122). Data collection has been supported by a grant provided by the French State and handled by the \"Agence Nationale de la Recherche,\" within the framework of the \"Investments for the Future\" programme, under the reference ANR-10-COHO-002, Observatoire Français de la Sclérose en Plaques (OFSEP).
摘要：
未经评估：社会经济地位对多发性硬化症患者死亡率的影响尚不清楚。目的是根据社会经济状况检查多发性硬化症的死亡率。
UNASSIGNED：采用回顾性观察队列设计，招募来自18个法国多发性硬化症专家中心的人员参加了FrançaisdelaSclérose斑块观察。所有患者均居住在法国大都市，根据Poser或McDonald标准明确或可能诊断为多发性硬化症，并在1960年至2015年之间发病。初始表型为复发发作或原发性进行性发作。生命状态于2016年1月1日更新。社会经济地位由生态指数衡量，欧洲剥夺指数，并根据每位患者的家庭住址归因于他们。根据社会经济状况，使用带有多维惩罚样条的加性超额危险模型研究了超额死亡率。最初的假设是超额死亡率的潜在社会经济梯度。
UNASSIGNED：共纳入34,169例多发性硬化症患者（88％复发发作（n=30,083），12%进行性发作（n=4086），复发性发作的女性/男性性别比为2.7，进行性发作为1.3）。复发发作的平均年龄为31.6（SD=9.8），进行性发作的平均年龄为42.7（SD=10.8）。在后续行动结束时，1849例患者死亡（4.4%为复发性发作（n=1311），13.2%为进行性发作（n=538））。对于复发患者发现了社会经济梯度；更贫困的患者有更高的超额死亡率。在1980年的疾病持续时间30年和症状发作一年时，被剥夺的复发发作患者（EDI=-6）和被剥夺的复发发作患者（EDI=12）之间的生存概率差异（或剥夺差距）男性为16.6％（95％置信区间（CI）[10.3％-22.9％]），女性为12.3％（95CI[7.6％-17.0％]）。在进行性发作患者中未发现明确的社会经济死亡率梯度。
UNASSIGNED：社会经济状况与复发患者多发性硬化症死亡率相关。改善更多社会经济贫困的多发性硬化症患者的整体护理可能有助于减少多发性硬化症相关死亡率的社会经济不平等。
UNASSIGNED：本研究由ARSEP基金会资助，该基金会是“在ScléroseSclérose牌匾上的援助基金会”（授权参考编号1122）。数据收集得到了法国国家提供的赠款的支持，并由国家机构处理，在“未来投资”计划的框架内，在参考号ANR-10-COHO-002下，法国恐怖主义观察(OFSEP)。
UNASSIGNED：采用回顾性观察队列设计，招募来自18个法国多发性硬化症专家中心的人员参加了FrançaisdelaSclérose斑块观察。所有患者均居住在法国大都市，根据Poser或McDonald标准明确或可能诊断为多发性硬化症，并在1960年至2015年之间发病。初始表型为复发发作或原发性进行性发作。生命状态于2016年1月1日更新。社会经济地位由生态指数衡量，欧洲剥夺指数，并根据每位患者的家庭住址归因于他们。根据社会经济状况，使用带有多维惩罚样条的加性超额危险模型研究了超额死亡率。最初的假设是超额死亡率的潜在社会经济梯度。
UNASSIGNED：共纳入34,169例多发性硬化症患者（88％复发发作（n=30,083），12%进行性发作（n=4086），复发性发作的女性/男性性别比为2.7，进行性发作为1.3）。复发发作的平均年龄为31.6（SD=9.8），进行性发作的平均年龄为42.7（SD=10.8）。在后续行动结束时，1849例患者死亡（4.4%为复发性发作（n=1311），13.2%为进行性发作（n=538））。对于复发患者发现了社会经济梯度；更贫困的患者有更高的超额死亡率。在1980年的疾病持续时间30年和症状发作一年时，被剥夺的复发发作患者（EDI=-6）和被剥夺的复发发作患者（EDI=12）之间的生存概率差异（或剥夺差距）男性为16.6％（95％置信区间（CI）[10.3％-22.9％]），女性为12.3％（95CI[7.6％-17.0％]）。在进行性发作患者中未发现明确的社会经济死亡率梯度。
UNASSIGNED：社会经济状况与复发患者多发性硬化症死亡率相关。改善更多社会经济贫困的多发性硬化症患者的整体护理可能有助于减少多发性硬化症相关死亡率的社会经济不平等。
UNASSIGNED：本研究由ARSEP基金会资助，该基金会是“在ScléroseSclérose牌匾上的援助基金会”（授权参考编号1122）。数据收集得到了法国国家提供的赠款的支持，并由国家机构处理，在“未来投资”计划的框架内，在参考号ANR-10-COHO-002下，法国恐怖主义观察(OFSEP)。
