Introduction

We aimed to analyze the accumulative risk of MRI and OB factors for evolution from RIS to MS in subjects included in the Argentinean MS registry (NCT03375177).

Methods

RIS subjects were identified according to RIS diagnosis criteria. Subjects were longitudinally followed with clinical and MRI at intervals of 6 months. Time from RIS identification to the first clinical event was estimated using Kaplan–Meier. Multivariable Cox regression models were created to assess the independent predictive value of demographic characteristics, as well as clinical, OB and MRI data on time to the first clinical event. The single and increased risk factor of evolution of RIS was quantified.

Results

A total of 88 RIS subjects, mean follow-up time 42 ± 4 months were included. 39 (44.3%) and 23 (26.1%) had a new MRI lesion or a clinical event, respectively, during the follow-up. OB (HR 5.9, 95% CI 1.29–10.1, p = 0.004), infratentorial lesions (HR 3.7, 95% CI 1.09–7.5) and spinal cord lesions (HR 5.3, 95% CI 1.4–8.2, p = 0.01) at RIS identification were independent predictors associated with a subsequent clinical event. The accumulative risk showed that when two of the three factors (OB, infratentorial or spinal cord lesions) were present the HR was 10.4, 95% CI 4.4–22, p < 0.001, and when three factors were present, it was HR 15.6, 95% CI 5.7–28, p < 0.001 for a relapse.

Conclusion

The presence of three factors significantly increased the risk of clinical event; high-risk subjects should probably be managed by a different approach than those used for individuals without high-risk factors.

中文翻译：

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阿根廷高危放射学孤立综合征临床事件的累积风险：来自全国登记处 RelevarEM 的数据

介绍

我们旨在分析阿根廷 MS 登记 (NCT03375177) 中包括的受试者从 RIS 演变为 MS 的 MRI 和 OB 因素的累积风险。

方法

根据RIS诊断标准确定RIS受试者。以 6 个月的间隔对受试者进行临床和 MRI 纵向跟踪。使用 Kaplan-Meier 估计从 RIS 识别到第一次临床事件的时间。创建多变量 Cox 回归模型以评估人口统计学特征以及临床、OB 和 MRI 数据对第一次临床事件的时间的独立预测值。量化了 RIS 演变的单一和增加的风险因素。

结果

共纳入 88 名 RIS 受试者，平均随访时间 42 ± 4 个月。在随访期间，分别有 39 名 (44.3%) 和 23 名 (26.1%) 患者出现了新的 MRI 病变或临床事件。在_  _ _  _ RIS 识别是与后续临床事件相关的独立预测因子。累积风险显示，当三个因素中的两个（OB、幕下或脊髓病变）存在时，HR 为 10.4，95% CI 4.4-22，p  < 0.001，当三个因素存在时，HR 为 15.6， 95% CI 5.7–28，p  < 0.001 表示复发。

结论

三个因素的存在显着增加了临床事件的风险；高风险受试者可能应该通过与没有高风险因素的个体不同的方法进行管理。