Lost time, lost function? Unraveling the impact of diagnosis delay on disability progression in multiple sclerosis

Address for correspondence: Maria Fernanda Hamamoto Leati (email: [e-mail]).

Abstract

Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system (CNS) with inflammatory and neurodegenerative components, and it is the most common nontraumatic disabling neurologic condition in young adults. The prevalence of MS has increased in recent decades, with greater life expectancy and functionality being attributed to a better understanding of the disease and its early diagnosis.

Objective: To correlate the delay in diagnosis and the onset of the first symptom with the Expanded Disability Status Scale (EDSS).

Methods: An observational study was performed, with 199 patients analyzed through chart reviews from the Demyelinating Outpatient Clinic from July to December 2023. Using data from the table, two groups were separated: time from the first symptom to diagnosis and time from the first symptom to the start of follow-up. In this sense, a comparison was made with the EDSS score and the number of years that patients took to start follow-up or receive the diagnosis. After tabulation, inferential and exploratory data analyses were performed. All analyses were performed using the IBM SPSS Statistics for Windows software, version 20.0. Statistical significance was established at p < 0.05.

Results: Using the Spearman rank correlation coefficient, we found that the group of time from the first symptom to diagnosis presented a coefficient of +0.277 (p < 0.05), while the group of time from the first symptom to the start of follow-up presented a coefficient of +0.337 (p < 0.05).

Conclusion: Although the correlation is intuitive, the data analyzed in the present study evidenced a weak relationship between these variables, and this result might be attributed to two important limitations of the study: the intervals were counted in years, not in months, and the EDSS was applied by different examiners using different methodologies. Therefore, it is necessary to broaden the scope of the present study, aiming for better correction of variables and potential biases.

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Artikel online veröffentlicht:
02. Oktober 2024