Analysis Of Survival Status And Related Risk Factors In Neuromyelitis Optica With More Than 5 Years

Objective:To evaluate the long-term survival status in NMO and investigate factors that impact disability and health-related quality of life(HRQOL).Methods:We collected main demographic and clinical characteristics and administered a series of questionnaires on disability(EDSS),HRQOL(MSIS-29),anxiety(GAD-7),depression(PHQ-9),fatigue(MFIS)to 40patients with more than 5 years followed up in the Second Hospital of Hebei Medical University.We assessed the relationships between gender,onset age,education level,marital status,first symptom,autoimmunity disease,disease duration,annual relapse rate(ARR)and EDSS,and the relationships between disability,anxiety,depression,fatigue and HRQOL.Result:1.For 40 patients with NMO,the rate of male and female was 1:7,mean age of onset was 34.6±12.9 years.For 37 survival patients,the median disease duration was 7 years(range 5-19 years),5 cases(13.5%)with mild disability,26 cases(70.3%)with moderate disability and 6 cases(16.2%)with severe disability.The incidences of fatigue,anxiety,depression were 10.8%,35.1%,37.8%respectively.2.The onset age and ARR were positively correlated with EDSS(P<0.05),and female had higher EDSS score than male(P=0.028).Multiple stepwise linear regression analysis showed that ARR and onset age were the important predictors of EDSS(r~2=0.330,P=0.001).3.Disability,fatigue,anxiety and depression had a bad influence on HRQOL in patients with NMO(P<0.05)and EDSS had high positive correlation with HRQOL(r=0.870,P<0.001).Multiple stepwise linear regression analysis further revealed that EDSS and depression were the main predictors of HRQOL(r~2=0.842,P<0.001).Conclusion:1.The patients with NMO were mostly young and middle aged women.The degree of disability in NMO was increased year by year and up to half patients coexisted with emotional disorders.2.ARR and onset age were main predictors of disability in NMO.3.Disability and depression were independent predictors of poor HRQOL in NMO.