Emergency department use before multiple sclerosis: Presenting complaints and discharge diagnoses

Area of Science:

• Neurology
• Healthcare Utilization
• Epidemiology

Background:

• Emergency department (ED) visits are a significant part of healthcare usage.
• While increased ED utilization before multiple sclerosis (MS) diagnosis is known, the specifics remain unclear.

Purpose of the Study:

• To characterize ED use and clinical context in the five years preceding MS diagnosis.
• To compare ED visit rates and discharge diagnoses between individuals with and without MS.

Main Methods:

• Population-based matched cohort study using linked administrative health data from British Columbia, Canada.
• Identified persons with multiple sclerosis (PwMS) and matched them to controls without MS.
• Analyzed ED encounters in the 5 years before the index date (first demyelinating disease claim).

Main Results:

• Included 2383 PwMS and 11,896 controls; mean age 44.1 years, 69.2% female.
• ED visit rates were higher in PwMS, increasing from 1.38 at 5 years pre-index to 3.40 in the year before diagnosis.
• Excess ED visits were for gastrointestinal, genitourinary, musculoskeletal, respiratory, mental health, and ill-defined conditions; PwMS had higher odds of non-specific discharge diagnoses.

Conclusions:

• ED utilization was consistently elevated in the 5 years prior to MS recognition.
• These pre-diagnosis ED visits predominantly involved non-neurologic and non-specific conditions.