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.
- transverse myelitis
- acute disseminated encephalomyelitis
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Contributors Study concept/design: CHC, CKT and JTL; data collection and analysis: CHC, CKT, JTL, IJT, IKW, CHT and CYH; data interpretation: CHC, CKT, LML, JTL, JHY, CCL, YFS, FCY and CLT; manuscript writing: CHC, CKT and JTL. All authors have given their final approval of the version to be published.
Funding This work was supported in part by grants from the Ministry of Science and Technology (MOST 106-2314-B-016-010, MOST 105-2314-B-016-004 and MOST 106-2314-B-016-007-MY2), Ministry of National Defense Medical Affairs Bureau (MAB-106-041 and MAB-106-044), Tri-Service General Hospital (TSGH-C105-082, TSGH-C107-073, TSGH-C106-068, TSGH-C107-072, TSGH-C107-074 and TSGH-C108-006-007-007-S05), Cheng Hsin General Hospital (CH-NDMC-106-13), the Ministry of Health and Welfare, Taiwan (MOHW107-TDU-B-212-123004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10701010021), Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.
Competing interests No, there are no competing interests for any author.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data are available in a public, open access repository. There are no data in this work. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. No data are available. All data relevant to the study are included in the article or uploaded as supplementary information.
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