Survival in commercially insured multiple sclerosis patients and comparator subjects in the U.S.
Survival in commercially insured multiple sclerosis patients and comparator subjects in the U.S.
复制标题
美国商业保险多发性硬化症患者和对照受试者的生存率
DOI：
10.1016/j.msard.2013.12.003
复制
发表时间：
2014
影响因子：
4
通讯作者：
Cutter,G
中科院分区：
文献类型：
--
作者：
Kaufman,DW;Reshef,S;Golub,HL;Peucker,M;Corwin,MJ;Goodin,DS;Knappertz,V;Pleimes,D;Cutter,G
比较来自美国商业健康保险数据库的多发性硬化症（MS）患者与匹配的非MS受试者队列的生存率。方法包括OptumInsight Research（OIR）数据库中1996年至2009年的30,402例MS患者和89,818例非MS受试者（对照者）。MS诊断需要至少连续3个月的数据库报告，两个或多个ICD-9代码340至少间隔30天，或1个ICD-9-340代码和至少1个MS疾病修饰治疗（DMT）代码的组合。对照药物要求在整个数据库报告中不存在ICD-9-340和DMT代码。每例患者最多匹配3种对照药物：首个相关代码年份的年龄（索引年-要求该年至少报告3个月）;性别;索引年居住地区。根据国家死亡指数和社会保障管理局死亡总档案确定死亡人数。未确定为死亡的受试者被假定为存活至2009年底。结果MS患者的年死亡率为899/10万，对照组为446/10万。与美国人口相比，标准化死亡率分别为1.70和0.80。Kaplan-Meier分析得出的中位生存率从出生时是6年低MS患者比comparator.ConclusionsThe结果显示，第一次在美国人口，生存劣势为当代MS患者相比，非MS受试者从同一个医疗保健系统。寿命缩短6年与最近来自不列颠哥伦比亚省的一份报告相似。
ObjectiveCompare survival in patients with multiple sclerosis (MS) from a U.S. commercial health insurance database with a matched cohort of non-MS subjects.Methods30,402 MS patients and 89,818 non-MS subjects (comparators) in the OptumInsight Research (OIR) database from 1996 to 2009 were included. An MS diagnosis required at least 3 consecutive months of database reporting, with two or more ICD-9 codes of 340 at least 30 days apart, or the combination of 1 ICD-9-340 code and at least 1 MS disease-modifying treatment (DMT) code. Comparators required the absence of ICD-9-340 and DMT codes throughout database reporting. Up to three comparators were matched to each patient for: age in the year of the first relevant code (index year – at least 3 months of reporting in that year were required); sex; region of residence in the index year. Deaths were ascertained from the National Death Index and the Social Security Administration Death Master File. Subjects not identified as deceased were assumed to be alive through the end of 2009.ResultsAnnual mortality rates were 899/100,000 among MS patients and 446/100,000 among comparators. Standardized mortality ratios compared to the U.S. population were 1.70 and 0.80, respectively. Kaplan–Meier analysis yielded a median survival from birth that was 6 years lower among MS patients than among comparators.ConclusionsThe results show, for the first time in a U.S. population, a survival disadvantage for contemporary MS patients compared to non-MS subjects from the same healthcare system. The 6-year decrement in lifespan parallels a recent report from British Columbia.