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Outcomes of Cardiovascular Surgery in Patients With Multiple Sclerosis
Jose L Diz Ferre1, Guangjin Zhou2, Alexander Cabulong1
1Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
JAMA Surgery
|June 10, 2026
Summary
Patients with multiple sclerosis (MS) undergoing cardiovascular surgery did not experience higher mortality or complications. However, those with MS had fewer routine home discharges, suggesting a need for optimized perioperative care.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Public Health
Background:
- Multiple sclerosis (MS) is linked to increased heart failure and myocardial infarction incidence.
- Autonomic dysregulation in MS patients can cause perioperative hemodynamic instability.
- Limited data exists on cardiovascular surgery outcomes for MS patients.
Purpose of the Study:
- To determine US nationwide morbidity and mortality rates in patients with MS undergoing cardiovascular surgery.
- To analyze the association between MS and surgical outcomes.
- To identify factors influencing perioperative care and discharge disposition in MS patients.
Main Methods:
- Cross-sectional study using the National Inpatient Sample database (2016-2022).
- Included patients undergoing coronary artery bypass grafting, valve, aortic, or combined cardiovascular surgery.
- Balancing-score matched cohort analysis to evaluate MS association with outcomes.
Main Results:
- No significant difference in in-hospital mortality between MS and non-MS cohorts (2.0% vs 3.7%).
- Comparable composite complication endpoint prevalence (50% vs 51%) including stroke, renal failure, and infections.
- Lower prevalence of routine home discharges in the MS cohort (28% vs 36%).
Conclusions:
- MS is not associated with increased in-hospital mortality or complications after cardiovascular surgery.
- Patients with MS show a significantly lower rate of routine home discharges post-surgery.
- A multidisciplinary team approach involving neurological experts is recommended to optimize perioperative care and improve discharge outcomes for MS patients.
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