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Published on: June 30, 2014
Hospitalization rates and discharge status in multiple sclerosis
Sanober Nusrat1, David Levinthal, Klaus Bielefeldt
1University of Pittsburgh Medical Center, Division of Gastroenterology, 200 Lothrop Dr., Pittsburgh, PA 15213, USA.
Abstract:
Management of multiple sclerosis (MS) has shifted from supportive to disease modifying therapy. Considering the increasingly widespread adoption of this approach in managing MS patients, we hypothesized that hospitalizations and surrogates of disease-related complications should have declined during the last decade. Methods. Using the Nationwide Inpatient Sample, hospitalizations for MS and associated secondary diagnoses and procedures as well as discharge status were examined. Time trends were examined for different age cohorts focusing on the period from 2001 to 2010. Results. During the preceding decade, annual hospitalizations for MS increased by 40%, with stable rates in all age groups except geriatric patients, who accounted for a significantly higher fraction of admissions. Nursing home transfers as a surrogate marker of disability remained unchanged for all age groups. Similarly, urinary tract infections, the need for skin debridement, or gastrostomy tube placement did not vary during the decade. Conclusion. During a time of increased adoption of disease modifying therapy, MS-related hospitalizations continued to increase and surrogate measures of disability in admitted patients remained stable, demonstrating the still significant impact of the disease on affected individuals.
Insights
Despite advances in disease-modifying therapies for multiple sclerosis (MS), hospitalizations for MS increased by 40% over a decade. Disability markers in hospitalized patients remained stable, indicating the persistent burden of MS.
Area of Science:
- Neurology
- Public Health
Background:
- Multiple sclerosis (MS) management has evolved towards disease-modifying therapies (DMTs).
- Increased adoption of DMTs led to the hypothesis of reduced MS-related hospitalizations and complications.
Purpose of the Study:
- To investigate trends in multiple sclerosis hospitalizations and disease-related complications.
- To analyze these trends over a decade (2001-2010) across different age groups.
Main Methods:
- Utilized the Nationwide Inpatient Sample database.
- Examined hospitalizations for MS, secondary diagnoses, procedures, and discharge status.
- Analyzed time trends for various age cohorts.
Main Results:
- Annual MS hospitalizations increased by 40% from 2001 to 2010.
- Geriatric patients showed a significantly higher admission rate.
- Disability surrogates (nursing home transfers, UTIs, skin debridement, gastrostomy tubes) remained unchanged.
Conclusions:
- MS hospitalizations rose despite increased DMT use.
- Disability indicators among admitted MS patients showed no improvement.
- Multiple sclerosis continues to significantly impact affected individuals, necessitating ongoing management strategies.
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