Factores pronósticos asociados a mayor discapacidad funcional en pacientes con Esclerosis Múltiple Recurrente Remitente atendidos en el Hospital de Especialidades Teodoro Maldonado Carbo.

Abstract

Introduction: Multiple Sclerosis is an autoimmune and chronic-degenerative disease of the central nervous system with variable clinical manifestations and heterogeneous presentation forms that hinder the prognosis of its evolution towards functional disability. Objective: To measure the strength of association between the factors of poor prognosis and the degree of functional disability present in patients with Recurrent Remitting Multiple Sclerosis (RRMS) treated at Hospital de Especialidades Teodoro Maldonado Carbo. Materials and Methods: This retrospective cohort study included a total of 80 RRMS patients. Clinical characteristics were described, and multinomial logistic regression models were calculated regarding the degree of functional disability to assess the prognostic impact of the identified factors. Results: Of the total of patients, 33.8% had mild disability (EDSS = 0-2.5), 41.3% had moderate disability (EDSS = 3-5.5) and 25.0% had severe disability (EDSS = 6- 10). Age >30 years at disease onset was associated with an increased risk of moderate disability (RR 7.32, 95% CI 1.29-41.69, p=0.025) and incomplete remission after the second clinical attack (RR 18.94; 95% CI 2.22-161.57; p=0.007) together with acute hospitalization by non-obstetric cause (RR 13.15, 95% CI 1.68-103.02; p = 0.014) were associated with an increased risk of severe disability. Conclusions: The poor prognosis factors that proved to be good predictors for the development of functional disability were age >30 years at the onset of the disease, incomplete remission of the second clinical attack and having some acute hospitalization.