ArticleMovement disorders clinical practice2023
Development and Validation of a Prognostic Model to Predict Overall Survival in Multiple System Atrophy.
Article in Movement disorders clinical practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A meta-analysis of survival and prognostic factors in multiple system atrophy.Journal of neurology · 2025Pooled it
- Extensive dysautonomia in early-stage multiple system atrophy reflects survival differences: insights from data-driven subtypes.Journal of neurology · 2026Article
- Natural history and 12-month progression of multiple system atrophy in a Chinese cohort.BMC neurology · 2026Observational
- Heart rate variability provides prognostic value in multiple system atrophy.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- A case report of syndrome of inappropriate antidiuretic hormone secretion unveiling hypothalamic involvement in multiple system atrophy.Frontiers in endocrinology · 2026Article
- Trends in Invasive Interventions and Risk Factors for Early Critical Events in Multiple System Atrophy.Cerebellum (London, England) · 2025Article
- Differences in the Impact of Intensive Rehabilitation on Hereditary Ataxias and the Cerebellar Subtype of Multiple System Atrophy.Cerebellum (London, England) · 2024Article
- Sex-related differences in the clinical presentation of multiple system atrophy.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Review
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Authors and funding
57 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Multiple system atrophy (MSA) is a devastating disease characterized by a variable combination of motor and autonomic symptoms. Previous studies identified numerous clinical factors to be associated with shorter survival. Objective: To enable personalized patient counseling, we aimed at developing a risk model of survival based on baseline clinical symptoms. Methods: MSA patients referred to the Movement Disorders Unit in Innsbruck, Austria, between 1999 and 2016 were retrospectively analyzed. Kaplan-Meier curves and multivariate Cox regression analysis with least absolute shrinkage and selection operator penalty for variable selection were performed to identify prognostic factors. A nomogram was developed to estimate the 7 years overall survival probability. The performance of the predictive model was validated and calibrated internally using bootstrap resampling and externally using data from the prospective European MSA Study Group Natural History Study. Results: A total of 210 MSA patients were included in this analysis, of which 124 patients died. The median survival was 7 years. The following clinical variables were found to significantly affect overall survival and were included in the nomogram: age at symptom onset, falls within 3 years of onset, early autonomic failure including orthostatic hypotension and urogenital failure, and lacking levodopa response. The time-dependent area under curve for internal and external validation was >0.7 within the first 7 years of the disease course. The model was well calibrated showing good overlap between predicted and actual survival probability at 7 years. Conclusion: The nomogram is a simple tool to predict survival on an individual basis and may help to improve counseling and treatment of MSA patients.
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