2024
Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohort
2023
Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging
de Havenon A, Parasuram N, Crawford A, Mazurek M, Chavva I, Yadlapalli V, Iglesias J, Rosen M, Falcone G, Payabvash S, Sze G, Sharma R, Schiff S, Safdar B, Wira C, Kimberly W, Sheth K. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. Journal Of The American Heart Association 2023, 12: e029242. PMID: 37218590, PMCID: PMC10381997, DOI: 10.1161/jaha.122.029242.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrainFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesRetrospective StudiesWhite MatterConceptsWhite matter hyperintensitiesMagnetic resonance imagingSevere white matter hyperintensitiesConventional magnetic resonance imagingResonance imagingRetrospective cohortEmergency departmentMatter hyperintensitiesVascular risk factorsProspective observational studyVascular cognitive impairmentTesla magnetic resonance imagingArea Deprivation IndexProspective cohortAdult patientsAcute careRisk factorsCardiovascular diseaseObservational studyCognitive impairmentPatientsCare magnetic resonance imagingIntermodality agreementCohortDeprivation indexHigher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses
Renedo D, Acosta J, Koo A, Rivier C, Sujijantarat N, de Havenon A, Sharma R, Gill T, Sheth K, Falcone G, Matouk C. Higher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses. Stroke 2023, 54: 1538-1547. PMID: 37216451, PMCID: PMC10212531, DOI: 10.1161/strokeaha.122.041891.Peer-Reviewed Original ResearchMeSH KeywordsHemorrhagic StrokeHospitalsHumansPopulation HealthRetrospective StudiesRisk FactorsStrokeConceptsHospital Frailty Risk ScoreRisk of strokeHighest Hospital Frailty Risk ScoresDate of consentFrailty Risk ScoreMendelian randomization analysisStroke riskRisk scoreRandomization analysisTime of enrollmentAvailable electronic health recordsMendelian randomizationElectronic health recordsLook-back periodIncident strokeDose-response wayFrailty statusHemorrhagic strokeMultivariable analysisStroke eventsObservational studyHigh riskFrailtySignificant associationSimilar associationEmergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa
Ammar A, Elsamadicy A, Ammar M, Reeves B, Koo A, Falcone G, Hwang D, Petersen N, Kim J, Beekman R, Prust M, Magid-Bernstein J, Acosta J, Herbert R, Sheth K, Matouk C, Gilmore E. Emergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa. Clinical Neurology And Neurosurgery 2023, 226: 107621. PMID: 36791588, DOI: 10.1016/j.clineuro.2023.107621.Peer-Reviewed Original ResearchMeSH KeywordsAdultCerebral HemorrhageDrainageFactor XaFactor Xa InhibitorsFibrinolytic AgentsHumansProspective StudiesRecombinant ProteinsRetrospective StudiesThrombosisConceptsAndexanet alfaExtra-axial hemorrhageEVD placementThrombotic eventsNew hemorrhagePrimary safety outcomeExternal ventricular drain placementLarge prospective studiesIntensive care unitIntracerebral hemorrhage patientsVentricular drain placementBolus patientsHospital lengthHospital LOSICU LOSTract hemorrhageRankin scoreSecondary outcomesAdult patientsBolus groupPrimary outcomeCare unitIntracerebral hemorrhageLong administration timeHemorrhage patients
2022
Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage
Bevers M, Booraem C, Li K, Sreekrishnan A, Sastre C, Falcone G, Sheth K, Sansing L, Kimberly W. Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage. Neurology 2022, 100: e1329-e1338. PMID: 36549913, PMCID: PMC10065211, DOI: 10.1212/wnl.0000000000206764.Peer-Reviewed Original ResearchMeSH KeywordsBrain EdemaCerebral HemorrhageEdemaHematomaHumansImmunityInterleukin-1 Receptor-Like 1 ProteinRetrospective StudiesConceptsSoluble ST2Deep intraparenchymal hemorrhageIntraparenchymal hemorrhagePerihematomal edemaImmune responseHematoma volumePoor outcomeFunctional outcomeMedian admission Glasgow Coma Scale scoreScale scoreAdmission Glasgow Coma Scale scorePeripheral innate immune responseModified Rankin Scale scoreGlasgow Coma Scale scoreHours of ictusPeripheral immune responseSecondary brain injuryRankin Scale scoreInnate immune cellsImmune cell populationsIntracerebral Hemorrhage ScoreSerial CT scansInnate immune responseHuman brain tissueSST2 levelsCT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke
Avery EW, Behland J, Mak A, Haider SP, Zeevi T, Sanelli PC, Filippi CG, Malhotra A, Matouk CC, Griessenauer CJ, Zand R, Hendrix P, Abedi V, Falcone GJ, Petersen N, Sansing LH, Sheth KN, Payabvash S. CT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke. NeuroImage Clinical 2022, 34: 103034. PMID: 35550243, PMCID: PMC9108990, DOI: 10.1016/j.nicl.2022.103034.Peer-Reviewed Original ResearchMeSH KeywordsArterial Occlusive DiseasesHumansRetrospective StudiesRisk AssessmentStrokeThrombectomyTomography, X-Ray ComputedTreatment OutcomeConceptsLarge vessel occlusion strokeIndependent cohortPrognostication toolsMechanical thrombectomyRisk stratificationOcclusion strokeExternal cohortAnterior circulation large vessel occlusion strokeOutcome predictionAcute stroke triageAnterior circulation territoryRadiomic featuresTime of admissionGeisinger Medical CenterLVO stroke patientsReliable clinical informationSignificant differencesAdmission CTAStroke patientsPrognostic informationFavorable outcomeStroke triageTreatment decisionsMedical CenterRadiomics signature
2021
Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion
Mak A, Matouk C, Avery EW, Behland J, Frey D, Madai VI, Vajkoczy P, Malhotra A, Karam A, Sanelli P, Falcone GJ, Petersen NH, Sansing L, Sheth KN, Payabvash S. Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion. Journal Of NeuroInterventional Surgery 2021, 14: 985-991. PMID: 34645705, DOI: 10.1136/neurintsurg-2021-017785.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaCerebral InfarctionHumansRetrospective StudiesStrokeThrombectomyTreatment OutcomeConceptsLarge vessel occlusionFinal infarct volumeLarger final infarct volumeWorse discharge outcomesInfarct volumeAdmission NIHSSDischarge outcomesVessel occlusionScale scoreMultivariate analysisAnterior large vessel occlusionLower admission NIHSS scoreHealth Stroke Scale scoreAdmission National InstitutesAdmission stroke severityPoor discharge outcomeStroke Scale scoreLarger infarct volumesAdmission NIHSS scoreRankin Scale scoreVoxel-wise analysisIncomplete reperfusionInfarct distributionOcclusion sideNIHSS scoreAndexanet Alfa Versus 4-Factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors in Intracranial Hemorrhage
Ammar AA, Ammar MA, Owusu KA, Brown SC, Kaddouh F, Elsamadicy AA, Acosta JN, Falcone GJ. Andexanet Alfa Versus 4-Factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors in Intracranial Hemorrhage. Neurocritical Care 2021, 35: 255-261. PMID: 33403588, PMCID: PMC10273779, DOI: 10.1007/s12028-020-01161-5.Peer-Reviewed Original ResearchConceptsFactor Xa inhibitorsSpontaneous intracranial hemorrhageSpontaneous intraparenchymal hemorrhageAndexanet alfaIntracranial hemorrhageProthrombin complex concentrateThrombotic eventsIntraparenchymal hemorrhageFunctional outcomeComplex concentrateXa inhibitorsFour-factor prothrombin complex concentrateOnset of ICHConsecutive adult patientsGood functional outcomeModified Rankin scoreSubgroup of patientsNumber of patientsThromboembolic eventsRankin scoreAdult patientsMedian ageRetrospective reviewHematoma volumeResultsA total
2020
Cause of death in spontaneous intracerebral hemorrhage survivors: Multistate longitudinal study.
Kuohn LR, Leasure AC, Acosta JN, Vanent K, Murthy SB, Kamel H, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Cause of death in spontaneous intracerebral hemorrhage survivors: Multistate longitudinal study. Neurology 2020, 95: e2736-e2745. PMID: 32917797, PMCID: PMC7734723, DOI: 10.1212/wnl.0000000000010736.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCaliforniaCause of DeathCerebral HemorrhageFloridaHumansInfectionsLongitudinal StudiesMiddle AgedNew YorkRetrospective StudiesSurvivorsConceptsCause of deathRecurrent intracranial hemorrhageIntracerebral hemorrhage survivorsAtrial fibrillationICH survivorsIschemic strokeIntracranial hemorrhageSpontaneous intracerebral hemorrhage survivorsMultivariable Cox proportional hazardsCox proportional hazardsLong-term survivalMedian followRespiratory failureHospital readmissionPrimary outcomePrimary diagnosisSpontaneous ICHCardiac diseaseClaims dataMultinomial logistic regressionNontraumatic ICHProportional hazardsAdult survivorsLogistic regressionPatientsAssociation of race and ethnicity to incident epilepsy, or epileptogenesis, after subdural hematoma.
Brown SC, King ZA, Kuohn L, Kamel H, Gilmore EJ, Frontera JA, Murthy S, Kim JA, Omay SB, Falcone GJ, Sheth KN. Association of race and ethnicity to incident epilepsy, or epileptogenesis, after subdural hematoma. Neurology 2020, 95: e2890-e2899. PMID: 32907969, PMCID: PMC7734738, DOI: 10.1212/wnl.0000000000010742.Peer-Reviewed Original ResearchConceptsSubdural hematomaEmergency departmentMultivariable Cox regressionRetrospective cohort studyMedical risk factorsDevelopment of epilepsyNontraumatic subdural hematomaAssociation of raceDiagnosis of epilepsyCohort studyPrimary outcomeRenal diseaseStatus epilepticusWhite patientsBlack patientsHospital revisitsCox regressionBlack raceDiagnosis codesRisk factorsClaims dataInjury severityEpilepsyDrug useSurvival analysisEffects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke
Al-Dasuqi K, Payabvash S, Torres-Flores GA, Strander SM, Nguyen CK, Peshwe KU, Kodali S, Silverman A, Malhotra A, Johnson MH, Matouk CC, Schindler JL, Sansing LH, Falcone GJ, Sheth KN, Petersen NH. Effects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke. Stroke 2020, 51: e193-e202. PMID: 32781941, PMCID: PMC7484023, DOI: 10.1161/strokeaha.120.029892.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArterial Occlusive DiseasesCerebral InfarctionCohort StudiesCollateral CirculationComputed Tomography AngiographyEndovascular ProceduresFemaleHumansInfarction, Middle Cerebral ArteryLinear ModelsMagnetic Resonance AngiographyMaleMiddle AgedReperfusionRetrospective StudiesStrokeThrombectomyTreatment OutcomeWhite MatterConceptsLarge vessel occlusion strokeFinal infarct volumeCollateral statusPoor collateral statusFavorable outcomeInfarct distributionInfarct volumeReperfusion successIndependent predictorsOcclusion strokeInternal capsuleAnterior circulation large vessel occlusion ischemic strokeLarge vessel occlusion ischemic strokeDeep white matter tractsBaseline collateral statusBorder-zone infarctionEarly favorable outcomeEarly functional outcomesRankin Scale scoreCohort of patientsDegree of reperfusionLarge vessel occlusionComputed tomography angiographyDeep white matterMagnetic resonance imagingStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitalsNon-Traumatic Subdural Hemorrhage and Risk of Arterial Ischemic Events
Murthy SB, Wu X, Diaz I, Parasram M, Parikh NS, Iadecola C, Merkler AE, Falcone GJ, Brown S, Biffi A, Ch'ang J, Knopman J, Stieg PE, Navi BB, Sheth KN, Kamel H. Non-Traumatic Subdural Hemorrhage and Risk of Arterial Ischemic Events. Stroke 2020, 51: 1464-1469. PMID: 32178587, PMCID: PMC7188584, DOI: 10.1161/strokeaha.119.028510.Peer-Reviewed Original ResearchConceptsArterial ischemic eventsAcute ischemic strokeIschemic eventsIschemic strokeSubdural hemorrhageMyocardial infarctionAntithrombotic therapyMedicare beneficiariesSDH diagnosisPatient riskSecondary analysisRetrospective cohort studyAcute myocardial infarctionCohort studyHazard ratioSecondary outcomesVascular comorbiditiesPrimary outcomeCox regressionDiagnosis codesClaims dataInternational ClassificationPrimary analysisInfarctionStrokeLiver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage
Parikh NS, Kamel H, Navi BB, Iadecola C, Merkler AE, Jesudian A, Dawson J, Falcone GJ, Sheth KN, Roh DJ, Elkind MSV, Hanley DF, Ziai WC, Murthy SB, Hanley D, Butcher K, Davis S, Gregson B, Lees K, Lyden P, Mayer S, Muir K, Steiner T. Liver Fibrosis Indices and Outcomes After Primary Intracerebral Hemorrhage. Stroke 2020, 51: 830-837. PMID: 31906832, PMCID: PMC7048169, DOI: 10.1161/strokeaha.119.028161.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageNonalcoholic fatty liver disease fibrosis scoreAspartate aminotransferase-platelet ratio indexAminotransferase-platelet ratio indexLiver fibrosis indexIntracerebral hemorrhageAdmission hematoma volumeHematoma volumeHematoma expansionFibrosis-4Fibrosis indexFibrosis scoreLiver diseaseMajor disabilityRatio indexNormal liver chemistriesAdvanced liver diseaseFibrosis-4 scoreRetrospective cohort studyPlatelet ratio indexPoor stroke outcomesSubclinical liver diseaseLogistic regression modelsLiver chemistriesRadiological outcomes
2019
Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy
Gusdon AM, Nyquist PA, Torres-Lopez VM, Leasure AC, Falcone GJ, Sheth KN, Sansing LH, Hanley DF, Malani R. Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy. Stroke 2019, 51: 129-136. PMID: 31744426, PMCID: PMC7048624, DOI: 10.1161/strokeaha.119.027085.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain EdemaCerebral HemorrhageEdemaFemaleHematomaHumansMaleMiddle AgedNeoplasmsRetrospective StudiesSeverity of Illness IndexConceptsBlood product transfusionThirty-day mortalityIntracerebral hemorrhagePerihematomal edemaActive malignancyProduct transfusionPHE volumeICH volumeActive cancerPHE growthPlatelet transfusionsCentral nervous system involvementRecurrence of malignancyNervous system involvementNontraumatic intracerebral hemorrhageCancer-specific dataPHE expansionRecent chemotherapyChart reviewConclusions PatientsControl patientsMost patientsHematoma volumeInstitutional databaseSystem involvementEarly Prognostication of 1-Year Outcome After Subarachnoid Hemorrhage: The FRESH Score Validation
Witsch J, Kuohn L, Hebert R, Cord B, Sansing L, Gilmore EJ, Hwang DY, Petersen N, Falcone GJ, Matouk C, Sheth KN. Early Prognostication of 1-Year Outcome After Subarachnoid Hemorrhage: The FRESH Score Validation. Journal Of Stroke And Cerebrovascular Diseases 2019, 28: 104280. PMID: 31326270, DOI: 10.1016/j.jstrokecerebrovasdis.2019.06.038.Peer-Reviewed Original ResearchConceptsSpontaneous subarachnoid hemorrhageModified Rankin ScaleLong-term outcomesSubarachnoid hemorrhageUnfavorable outcomePercent of patientsExclusion of patientsStratification of patientsScore variablesAneurysmal etiologyBleeding sourceRankin ScaleFunctional outcomeMean ageEarly prognosticationPrognostication scoresStudy investigatorsHospital resourcesPatientsDisability partAneurysm coilingOutcomesHigh gradeCharacteristic curveHemorrhageIntensive Blood Pressure Reduction and Perihematomal Edema Expansion in Deep Intracerebral Hemorrhage
Leasure AC, Qureshi AI, Murthy SB, Kamel H, Goldstein JN, Walsh KB, Woo D, Shi FD, Huttner HB, Ziai WC, Hanley DF, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Intensive Blood Pressure Reduction and Perihematomal Edema Expansion in Deep Intracerebral Hemorrhage. Stroke 2019, 50: 2016-2022. PMID: 31272326, PMCID: PMC6646091, DOI: 10.1161/strokeaha.119.024838.Peer-Reviewed Original ResearchConceptsDeep intracerebral hemorrhageIntensive BP reductionBasal ganglia intracerebral hemorrhageBlood pressure reductionIntracerebral hemorrhageBP reductionPoor outcomeATACH-2Intensive Blood Pressure ReductionPressure reductionPerihematomal edema expansionSecondary brain injurySupratentorial intracerebral hemorrhagePerihematomal edema volumeSpontaneous intracerebral hemorrhageRelevant end pointsDeep locationBaseline characteristicsEdema volumeBasal gangliaBrain injuryClinical trialsTomography scanEdema expansionTreatment groupsDecreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome
Petersen NH, Ortega-Gutierrez S, Wang A, Lopez GV, Strander S, Kodali S, Silverman A, Zheng-Lin B, Dandapat S, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Amin H, Cord B, Hebert RM, Matouk C, Sheth KN. Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome. Stroke 2019, 50: 1797-1804. PMID: 31159701, PMCID: PMC6787912, DOI: 10.1161/strokeaha.118.024286.Peer-Reviewed Original ResearchConceptsFinal infarct volumeWorse functional outcomeInfarct volumeEndovascular thrombectomyFunctional outcomeOcclusion strokeCerebral infarction 2b/3 reperfusionPressure reductionLarge vessel intracranial occlusionsGreater infarct growthBlood pressure reductionComprehensive stroke centerPercent of patientsBlood pressure managementLarger infarct volumesModified Rankin ScaleRankin Scale scoreMultivariable logistic regressionRelative hypotensionSustained hypotensionInfarct progressionNinety patientsInfarct growthIschemic penumbraIschemic stroke
2018
The Subjective Experience of Patients Undergoing Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus
Subramanian HE, Mahajan A, Sommaruga S, Falcone GJ, Kahle KT, Matouk CC. The Subjective Experience of Patients Undergoing Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus. World Neurosurgery 2018, 119: e46-e52. PMID: 29981467, DOI: 10.1016/j.wneu.2018.06.209.Peer-Reviewed Original ResearchConceptsIdiopathic normal pressure hydrocephalusShunt surgeryNormal pressure hydrocephalusPreoperative courseClinical responsePressure hydrocephalusPatient's clinical responseVentriculoperitoneal shunt surgeryCounseling of patientsSaturation of themesClinical courseComorbid conditionsConsecutive seriesPostoperative assessmentDefinitive diagnosisPatients' caregiversPatient outcomesChallenges patientsDiagnostic criteriaPatientsSurgeryTelephone interviewsHydrocephalusDiagnosisSubjective experience
2015
Epidemiology of multiple sclerosis: results from a large observational study in the UK
Jick SS, Li L, Falcone GJ, Vassilev ZP, Wallander M. Epidemiology of multiple sclerosis: results from a large observational study in the UK. Journal Of Neurology 2015, 262: 2033-2041. PMID: 26067217, PMCID: PMC4768220, DOI: 10.1007/s00415-015-7796-2.Peer-Reviewed Original ResearchConceptsUnderlying autoimmune processHazard ratioCause mortalityAutoimmune processMS patientsUK Clinical Practice Research DatalinkClinical Practice Research DatalinkIncident MS casesAdjusted hazard ratioUrinary tract infectionCox proportional regressionMultiple sclerosis progressionPrimary care dataConfidence intervalsLarge observational studiesIdentification of predictorsOriginal medical recordsCurrent smokingPatient comorbiditiesTract infectionsFrequent comorbiditiesLifestyle factorsMS diagnosisMultiple sclerosisPatient group