PREDICTION OF RISK OF DEVELOPMENT OF FATAL OUTCOME IN PATIENTS WITH MULTIPLE SCLEROSIS

The study is devoted to assessing the possibility of predicting a fatal outcome in multiple sclerosis (MS) depending on clinical, socio-hygienic, and medical-organizational factors. A retrospective observation was conducted on 1,827 patients with MS in the Republic of Tatarstan, who had available data on a fatal outcome or its absence within 5 years of inclusion in the MS registry. The number of MS patients who died within 5 years of inclusion in the register was 42, and the number of patients who were observed alive for at least 5 years after inclusion in the register was 1785. Results. Three predictors were included in the final multivariate prognostic model: the initial EDSS scores, the fact that the patient was prescribed ITRS, and the patient's age at the time of inclusion in the registry. The sensitivity and specificity of the obtained prognostic model were 76.2% and 81.7%, respectively. The positive and negative prognostic significance were 80.6% and 77.4%, respectively. Conclusion. The developed prognostic model includes the fact of prescription of PITRS as a predictor of a fatal outcome, which indicates a significant role of specific therapy for MS in the prognosis of the disease development. The determination of the five-year risk of a fatal outcome in patients with MS at the stage of registration and the beginning of treatment will allow to determine in a timely manner a group of high risk of an unfavorable outcome of the disease, in relation to which the tactics of intensification of medical monitoring and therapeutic interventions are justified, taking into account the identified risk factors.