Factores sociodemográficos y clínicos relacionados con la progresión de la discapacidad en pacientes con esclerosis múltiple
Palabras clave:
discapacidad, esclerosis múltiple, progresión de la discapacidad, predictores clínicosResumen
La esclerosis múltiple (EM) es una enfermedad desmielinizante crónica del sistema nervioso central (SNC), de pronóstico variable y con un impacto social significativo. La prevalencia en Colombia fue de 7,52 por 100.000 habitantes durante 2013 y ha aumentado en un 60% de 2009 a 2013. Objetivo: identificar los factores sociodemográficos y clínicos relacionados con la progresión de la discapacidad en la EM. Metodología: Se realizó un estudio descriptivo con componente analítico transversal utilizando la progresión de la discapacidad como variable dependiente. Las historias clínicas de 216 pacientes residentes en el Área Metropolitana del Valle de Aburrá, Antioquia, Colombia. Resultados: En el modelo multivariado, al ajustar el fenotipo de EM para las otras variables, los siguientes factores se asociaron con una mayor probabilidad de tener progresión de la discapacidad: primaria progresiva (OR 3,246, IC 95% 1,294 - 8,145, valor de p = 0,012); complicaciones cerebelosas (OR 2,498; IC del 95%: 1,186 - 5,265; valor de p = 0,016); fármacos antidepresivos (OR 2,336; IC del 95%: 1,054 - 5,176; valor de p = 0,037); la presencia de otras enfermedades neurológicas (OR 3,392, IC del 95% 1,139 - 10,102, valor de p = 0,028); y lesiones activas en la resonancia magnética (OR 2,162; IC del 95%: 1,042 - 4,485, -P = 0,038). Aquellos con patologías distintas de las cardiovasculares, metabólicas, mentales, autoinmunes o infecciosas tuvieron una menor probabilidad de progresión de la discapacidad (OR 0,138, IC del 95%: 0,024 - 0,799, valor de p = 0,028). Conclusiones: Los resultados del presente trabajo pueden servir como punto de partida para el seguimiento de los pacientes, contribuyendo a la resolución de problemas y mejorando la calidad de vida de las personas con esta enfermedad.
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