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Updated: Feb 28, 2026
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Hospitalization is associated with subsequent disability in multiple sclerosis
Allan Garland1, Luanne M Metz2, Charles N Bernstein3
1Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Manitoba Centre for Health Policy, Winnipeg, Canada.
Background:
Although an increasing amount of research has evaluated interactions between MS and comorbid chronic disease, few data exist regarding the interactions between MS and acute illness. As compared to age and sex-matched persons without MS, persons with MS experience higher rates of hospitalization and critical illness, and higher mortality rates and health care utilization following critical illness. We aimed to determine whether acute illness requiring hospitalization is associated with progression of multiple sclerosis (MS).
Methods:
We conducted this population-based, retrospective cohort study by linking data from the regional MS Clinic in Calgary, Canada with the Canadian Discharge Abstract Database to identify non-obstetric hospitalizations. We included individuals with a confirmed diagnosis of MS, at least one recorded Expanded Disability Status Scale (EDSS) measurement, and known age of symptom onset of age 10 years or older. Using data from 2009 to 2014, we used generalized linear models with generalized estimating equations to establish the association within individuals between hospitalization and the time course of MS-related disability (as measured by the EDSS), adjusting for sex, age, disease course at onset, and use of disease-modifying therapies.
Results:
We included 2104 individuals with MS in the analysis, who had a median of 4 EDSS measurements each. Of these 491 (23.3%) had at least one hospitalization. Most subjects were female, with a relapsing disease course at onset, and a mean (SD) age at symptom onset of 33.0 (10.0) years. The underlying rate of disability progression averaged 0.9 EDSS points per decade. Following hospitalization, there was a step increase in EDSS, averaging 0.23 points, equivalent to 2.5 years of time-related disease progression. Hospitalization did not alter the subsequent temporal rate of disability progression. The findings did not differ in those hospitalized for MS versus other reasons.
Conclusions:
Acute illness requiring hospitalization is associated with a worsening of MS-related disability.
Insights
Acute illness requiring hospitalization worsens multiple sclerosis (MS) disability, causing a significant step increase in Expanded Disability Status Scale scores. This worsening does not change the long-term rate of MS progression.
Area of Science:
- Neurology
- Clinical Research
- Epidemiology
Background:
- Limited research exists on the impact of acute illness on multiple sclerosis (MS) progression.
- Individuals with MS face higher hospitalization rates and mortality compared to the general population.
- Understanding acute illness effects is crucial for managing MS patient outcomes.
Purpose of the Study:
- To investigate the association between acute illness requiring hospitalization and the progression of disability in multiple sclerosis (MS).
Main Methods:
- Population-based retrospective cohort study using linked clinical and administrative data (2009-2014).
- Included individuals with confirmed MS diagnosis, EDSS measurements, and age of onset ≥10 years.
- Generalized linear models with GEE analyzed the association between hospitalization and EDSS changes, adjusting for covariates.
Main Results:
- 2104 individuals with MS were analyzed; 23.3% experienced at least one hospitalization.
- Hospitalization was associated with an average step increase of 0.23 EDSS points, equivalent to 2.5 years of progression.
- The rate of disability progression after hospitalization remained unchanged.
Conclusions:
- Acute illness leading to hospitalization is linked to an immediate worsening of MS-related disability.
- Hospitalization represents a significant event impacting the disability status of MS patients.
- Further research may explore interventions to mitigate the impact of acute illness on MS progression.
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