Critical Illness in Patients with Multiple Sclerosis: A Matched Case-Control Study.

Area of Science:

• Neurology
• Critical Care Medicine
• Epidemiology

Background:

• Multiple sclerosis (MS) can lead to critical care needs.
• Understanding reasons for neuro-intensive care unit (NICU) admission in MS patients is crucial.

Purpose of the Study:

• To investigate the causes of NICU admission for multiple sclerosis patients.
• To compare outcomes of MS patients in the NICU with non-MS controls.

Main Methods:

• Retrospective chart review of MS patients admitted to a tertiary hospital NICU (1993-2015).
• Matched analysis comparing MS patients with non-MS controls based on age and gender.
• Conditional logistic regression used to analyze admission causes, comorbidities, disease severity, and survival.

Main Results:

• Respiratory dysfunction was the primary reason for NICU admission in MS patients (34.4%), often infection-related.
• MS patients showed higher odds of NICU admission for respiratory dysfunction (OR=7.86) and non-respiratory infections (OR=3.71).
• MS patients had increased NICU re-admission rates (OR=2.53) and higher mortality post-admission (adjusted OR=4.21) compared to controls.

Conclusions:

• Respiratory dysfunction, frequently linked to infection, is the leading cause for NICU admission in multiple sclerosis patients.
• Critically ill MS patients experience higher NICU re-admission rates and mortality than their non-MS counterparts.
• Findings highlight the critical care vulnerabilities associated with advanced multiple sclerosis.