{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:38:59Z","timestamp":1789439939154,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,3,16]],"date-time":"2013-03-16T00:00:00Z","timestamp":1363392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>\n                      Multiple sclerosis (\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      ) patients are at increased infection risk. Here the influences of susceptibility, severity and surveillance bias on infection\u2010related hospital admission are assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Swedish registers identified 20\u00a0276 patients with\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      , matched with 203\u00a0951 people from the general population without MS. Risk of first hospital admission for infection and mortality over 36\u00a0years was estimated by Poisson regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multiple sclerosis was associated with an increased hospital admission risk for all infections, with an adjusted relative risk (and 95% confidence interval) of 4.26 (4.13\u20134.40). A proportion of this raised risk was probably due to surveillance and referral bias, although a raised risk remained when\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      was compared with other immune\u2010mediated diseases. The 1\u2010month mortality rate following hospital admission for infection was higher in\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      patients than in the comparison cohort, with a relative risk of 4.69 (4.21\u20135.22). There was no clear temporal trend in the results, and risks were higher in males and varied by MS phenotype.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Higher hospital admission rates among\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      patients for infection are likely to be due to a combination of surveillance bias, cautious medical management and greater susceptibility to severe infections.\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      \u2010related functional limitations may increase infection risk and this should be considered in\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      management.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.12130","type":"journal-article","created":{"date-parts":[[2013,3,17]],"date-time":"2013-03-17T00:15:01Z","timestamp":1363479301000},"page":"1153-1160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":108,"title":["Hospital admission due to infections in multiple sclerosis patients"],"prefix":"10.1111","volume":"20","author":[{"given":"S.","family":"Montgomery","sequence":"first","affiliation":[{"name":"Clinical Epidemiology and Biostatistics \u00d6rebro University Hospital and \u00d6rebro University \u00d6rebro"},{"name":"Clinical Epidemiology Unit and Centre for Pharmacoepidemiology Karolinska University Hospital Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Hillert","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska University Hospital Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bahmanyar","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit and Centre for Pharmacoepidemiology Karolinska University Hospital Karolinska Institutet Stockholm Sweden"},{"name":"Faculty of Medicine Golestan University of Medical Sciences Gorgan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awf098"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000233834.09743.3b"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.64.6.736"},{"key":"e_1_2_7_5_1","first-page":"67","article-title":"Urinary tract infections may trigger relapse in multiple sclerosis","volume":"19","author":"Metz LM","year":"1998","journal-title":"Axone"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458510394397"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6101-2"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)92801-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.65.1.56"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458510379244"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2012.03668.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458509107010"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000310301"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90099-X"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2007.02019.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-450"},{"key":"e_1_2_7_17_1","unstructured":"http:\/\/www.msreg.net\/cms\/sv\/home(accessed 15\/10\/2012)."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511403794"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-009-9350-y"},{"key":"e_1_2_7_20_1","unstructured":"Statistics Swedenhttp:\/\/www.scb.se\/default____2154.aspx(accessed 14\/10\/2012)."},{"key":"e_1_2_7_21_1","unstructured":"The Cause of Death Registerhttp:\/\/www.socialstyrelsen.se\/register\/dodsorsaksregistret\/. 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