The association between septicemia and the risk of multiple sclerosis: A nationwide register-based retrospective cohort study in Taiwan

Background: Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system. Few studies focused on the relationship between septicemia and MS. Aim: To evaluate the potential impact of septicemia on risk for MS. Design: Two cohorts of patients with septicemia and without septicemia were followed up for the occurrence of MS. Methods: Patients of 482 790 with septicemia was enrolled from the National Health Insurance Research Database between 2001 and 2011 as the study group to match the 1 892 820 individuals, as the control group, by age and gender. Incidence of MS in both groups was calculated. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR) for MS between groups. Results: Septicemia patients had a 3.06-fold (95% CI: 2.16-4.32, P < 0.001) greater risk of developing MS than the matched group. In addition, higher severity of septicemia was associated with higher risk of developing MS (moderate: HR ¼ 4.03, 95% CI: 2.53-6.45, P < 0.001; severe: HR ¼ 11.1, 95% CI: 7.01-17.7, P < 0.001). Similar results also occurred in both male and female patients with septicemia (male: HR ¼ 4.06, 95% CI: 2.17-7.58, P < 0.001; female: HR ¼ 2.72, 95% CI: 1.79-4.11, P < 0.001). Patients without counterpart comorbidities had a significantly higher risk of MS than the controlled group (HR ¼ 3.02, 95% CI: 2.10-4.35, P < 0.001). Conclusion: The results indicated septicemia is linked to an increased risk for MS. Aggressively preventing and treating septicemia may be warranted for one of precautionary strategies of MS.