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Updated: Jul 23, 2025
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Common comorbid and secondary conditions leading to hospitalization in multiple sclerosis patients in the United
Anthony O Asemota1, Eric B Schneider2, Ellen M Mowry3
1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Johns Hopkins Surgery Center for Outcomes Research, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States.
Objective:
To identify the burden of hospitalization and common primary admitting diagnoses among MS patients in the United States (US).
Background:
The burden of hospitalizations and conditions leading to hospitalizations in MS patients in the US has not been well described.
Design/Methods:
Using the Nationwide Inpatient Sample for 2001-2010, all patients with principal or secondary diagnosis of MS were identified, and the principal admitting diagnoses were compared with that of non-MS patients. Trends in hospitalizations were studied in specific age groups (1-9 yrs, 10-19 yrs, 20-29 yrs, 30-39 yrs, 40-49 yrs, 50-59 yrs, 60-69 yrs,70-79 yrs, 80-84 yrs and ≥85 yrs), and population level rates were obtained and compared with non-MS patients to obtain rate ratios (RR) and odds ratios (OR).
Results:
A total of 1,240,410 MS patients were identified representing 4 out of every 1000 US hospital admissions, with an estimated female/male ratio of 2.72/1. The median age for MS hospitalizations was 53 years (Interquartile range=18). The majority of all MS hospitalizations occurred in the 30-69-year age bracket (82.17 %). The average length of in-patient hospital stays for MS patients compared to the non-MS population was 5.8 vs. 4.5 days (p < 0.001), and more MS patients had Medicare insurance (50.36 % vs. 42.24 %, p < 0.001). Overall, conditions such as urinary tract infections (UTI) - (RR11.43, p < 0.001), septicemia (RR8.53, p < 0.001), pneumonia (RR2.84, p < 0.001), chronic skin ulcers (RR20.64, p < 0.001), and lower limb and femoral neck fractures (RR2.86, p < 0.001) were present with increased frequency among MS patients. Patterns of comorbidity varied markedly by age group. The estimated average annual in-hospital charges adjusted to 2010 dollars for all MS inpatient hospitalizations was 3 billion U.S. dollars.
Conclusions:
Patients with MS are admitted into hospital at a younger age, are hospitalized longer and consume more Medicare resources than the similar patients without MS in the general population. Infections account for a large proportion of MS-associated hospitalizations, from young adulthood onward. These findings are particularly significant in light of the increasing availability of disease modifying therapies with more potent immunosuppressive properties, as well as the accumulating data that systemic infection can drive MS relapses.
Insights
Hospitalizations for Multiple Sclerosis (MS) patients in the US are significant, with infections being a common cause. MS patients experience longer hospital stays and higher costs compared to those without MS.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- The hospitalization burden and primary reasons for admission among Multiple Sclerosis (MS) patients in the United States (US) remain incompletely characterized.
- Understanding these factors is crucial for resource allocation and patient care strategies.
Purpose of the Study:
- To determine the prevalence of hospitalizations and identify common primary admitting diagnoses for MS patients in the US.
- To compare hospitalization patterns and associated conditions between MS patients and the general non-MS population.
Main Methods:
- Utilized the Nationwide Inpatient Sample (NIS) from 2001-2010 to identify MS patients.
- Analyzed principal admitting diagnoses, hospitalization trends across age groups, and compared outcomes (length of stay, insurance, comorbidities) with non-MS patients.
- Calculated rate ratios (RR) and odds ratios (OR) for specific conditions.
Main Results:
- Identified 1,240,410 MS hospitalizations, representing 0.4% of US admissions, with a female predominance (2.72:1).
- MS patients had longer hospital stays (5.8 vs. 4.5 days) and higher Medicare utilization.
- Commonly increased conditions included urinary tract infections (UTI), septicemia, pneumonia, chronic skin ulcers, and fractures, with significant associated costs ($3 billion annually).
Conclusions:
- MS patients are hospitalized more frequently, at younger ages, for longer durations, and incur higher healthcare costs than the general population.
- Infections are a major driver of MS-related hospitalizations, particularly from young adulthood onwards.
- These findings highlight the need to consider infection risks, especially with potent immunosuppressive therapies, and their potential to trigger MS relapses.
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