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Background <p>Multiple-system atrophy is a rapidly progressive neurodegenerative disease with incomplete survival data, limiting the understanding of long-term outcomes. This study aimed to investigate a comprehensive data including survival time and prognostic factors.</p> Methods <p>Individual patient data were pooled from studies reporting Kaplan–Meier curves, and then, survival curves were generated. The pooled median survival times were derived using weighted median of medians approach and hazard ratios of risk factors were analyzed using either fixed- or random-effects model.</p> Results <p>37 studies involving 6145 patients were included. The median survival time for MSA patients was 8.23&#xa0;years (95% CI 8.02–8.56) based on reconstructed individual patient data. The pooled weighted median time was 8.0&#xa0;years (95% CI 7.51–9.0). The following variables were found as unfavorable prognostic factors (hazard ratio with 95% CI are shown): age at onset (1.02, 1.01–1.03), poor levodopa response (1.55, 1.14–2.11), parkinsonism onset (1.30, 1.05–1.62), falls (1.84, 1.4–2.4), dysautonomia onset (1.48, 1.16–1.9), autonomic failure (2.52, 1.42–4.48), orthostatism hypotension (1.39, 1.16–1.66), bladder catheterization (1.81, 1.41–2.31), and stridor (1.5, 1.12–2.02).</p> Conclusion <p>Survival time in MSA was evaluated using multiple methodological approaches, revealing a median survival of 8.0&#xa0;years, and clinical variables like early autonomic failure and frequently falls were identified as predictors of poor survival outcomes.</p>

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A meta-analysis of survival and prognostic factors in multiple system atrophy

  • 期刊论文

  • 发表日期：

    2025年6月18日

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  • Xiao Dong,
  • Daji Chen,
  • Linlin Wan,
  • Linliu Peng,
  • Zhao Chen,
  • Riwei Ouyang,
  • Xiafei Long,
  • Kefang Du,
  • Xiaokang Wu,
  • Xinying Xiao,
  • Ruqing He,
  • Rong Qiu,
  • Beisha Tang,
  • Hong Jiang

摘要

Background

Multiple-system atrophy is a rapidly progressive neurodegenerative disease with incomplete survival data, limiting the understanding of long-term outcomes. This study aimed to investigate a comprehensive data including survival time and prognostic factors.

Methods

Individual patient data were pooled from studies reporting Kaplan–Meier curves, and then, survival curves were generated. The pooled median survival times were derived using weighted median of medians approach and hazard ratios of risk factors were analyzed using either fixed- or random-effects model.

Results

37 studies involving 6145 patients were included. The median survival time for MSA patients was 8.23 years (95% CI 8.02–8.56) based on reconstructed individual patient data. The pooled weighted median time was 8.0 years (95% CI 7.51–9.0). The following variables were found as unfavorable prognostic factors (hazard ratio with 95% CI are shown): age at onset (1.02, 1.01–1.03), poor levodopa response (1.55, 1.14–2.11), parkinsonism onset (1.30, 1.05–1.62), falls (1.84, 1.4–2.4), dysautonomia onset (1.48, 1.16–1.9), autonomic failure (2.52, 1.42–4.48), orthostatism hypotension (1.39, 1.16–1.66), bladder catheterization (1.81, 1.41–2.31), and stridor (1.5, 1.12–2.02).

Conclusion

Survival time in MSA was evaluated using multiple methodological approaches, revealing a median survival of 8.0 years, and clinical variables like early autonomic failure and frequently falls were identified as predictors of poor survival outcomes.