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Updated: Sep 3, 2025
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Association of multiple sclerosis with mortality in sepsis: a population-level analysis
Lavi Oud1, John Garza2,3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center at the Permian Basin, 701 W. 5th Street, Odessa, TX, 79763, USA. lavi.oud@ttuhsc.edu.
Background:
Multiple sclerosis (MS) is associated with increased risk of sepsis and higher sepsis-related mortality, compared to the general population. However, the evidence on the prognostic impact of MS in sepsis has been scarce. We aimed to evaluate the population-level association of MS with short-term mortality in sepsis.
Methods:
We performed a retrospective population-based cohort study using a statewide data set to identify hospitalizations aged ≥ 18 years in Texas with sepsis, with and without MS during 2010-2017. Multilevel logistic models were fit to estimate the association of MS with short-term mortality among all sepsis hospitalizations, and for sensitivity analyses among hospitalizations with septic shock and those admitted to ICU.
Results:
Among 283,025 sepsis hospitalizations, 1687 (0.6%) had MS. Compared to sepsis hospitalizations without MS, those with MS were younger (aged ≥ 65 years 35.0% vs 56.8%), less commonly racial/ethnic minority (36.2% vs 48.1%), and had lower mean Deyo comorbidity index (1.6 vs 2.7). The rates of septic shock and ICU admission were similar for sepsis hospitalizations with and without MS (58.7% vs 59.6% and 46.7% vs 46.0%, respectively). The unadjusted short-term mortality among sepsis hospitalizations with and without MS for the whole cohort, among those with septic shock, and among ICU admissions were 20.2% vs 31.3%, 25.6% vs 40.0%, and 24.0% vs 34.8%, respectively. On adjusted analyses, MS was associated with 17% lower odds of short-term mortality (adjusted odds ratio [aOR] 0.828 [95% CI 0.723-0.947]). Similar findings were observed on sensitivity analyses of patients with septic shock (aOR 0.764 [95% CI 0.651-0.896]), but MS was not associated with mortality among sepsis hospitalizations admitted to ICU (aOR 0.914 [95% CI 0.759-1.101]).
Conclusions:
MS was associated with lower short-term mortality among septic patients, with findings consistent among the subset with septic shock. Among septic patients admitted to ICU, MS was not associated with mortality.
Insights
Multiple sclerosis (MS) patients had lower short-term mortality from sepsis. This protective effect was observed in septic shock cases but not in ICU admissions for sepsis.
Area of Science:
- Medical research
- Clinical epidemiology
- Sepsis research
Background:
- Multiple sclerosis (MS) is linked to higher sepsis risk and mortality.
- Limited data exists on the prognostic impact of MS in sepsis patients.
- This study investigates the association between MS and short-term mortality in sepsis.
Purpose of the Study:
- To evaluate the population-level association of MS with short-term mortality in sepsis.
- To analyze the impact of MS on sepsis outcomes in different patient subgroups.
Main Methods:
- Retrospective population-based cohort study using Texas statewide data (2010-2017).
- Identified hospitalizations aged ≥18 years with and without MS.
- Multilevel logistic models analyzed short-term mortality in sepsis, septic shock, and ICU admissions.
Main Results:
- Among 283,025 sepsis hospitalizations, 0.6% had MS.
- Patients with MS were younger and had fewer comorbidities.
- Adjusted analyses showed MS associated with 17% lower odds of short-term mortality (aOR 0.828).
- This association persisted in septic shock cases but not in ICU admissions.
Conclusions:
- Multiple sclerosis is associated with reduced short-term mortality in sepsis patients.
- The findings were consistent for septic shock but not for sepsis patients admitted to the ICU.
