Impact of Obesity on Hospitalization Outcomes Among Patients Admitted for Multiple Sclerosis Exacerbations: An Analysis of the National Inpatient Sample Database
Muhammad Sohaib1, Hafiz Maaz2, Muhammad Ahmed3, Haris Kamal4, Muhammad Tayyab Muzaffar Chaychi5
1Rollins Shool of Public Health, Emory University, 2Quaid-e-Azam Medical College, Bahawalpur Pakistan, 3Medical College of Georgia, Augusta University, 4University of Texas At Houston, 5University of South Florida
Objective:
To study the impact of obesity on hospitalisation outcomes among patients admitted for multiple sclerosis exacerbations by utilising the national inpatient sample database from 2016 to 2022.
Background:
Several studies have demonstrated a link between multiple sclerosis (MS) and obesity. However, the data on the impact of obesity on outcomes of multiple sclerosis exacerbations is limited.
Design/Methods:
We used the ICD-10 codes E66 for obesity and Z468 for BMI codings; G35 for multiple sclerosis. The outcomes of interest were length of stay (LOS), in-hospital mortality, discharge disposition, and total charges. All analyses used survey-weighted logistic regression to account for strata and discharge weights. We used multivariate regression models to adjust for confounders such as age, sex, race/ethnicity, comorbidity index, and APR-DRG severity/risk. The p-value was kept significant at ≤ 0.05 with a 95% confidence interval.
Results:
We identified 158,109.96 MS exacerbation admissions (non-obese 128,060.00; obese 30,049.99; obesity share 19.00%). Obese patients were younger (mean age 44.81 [95% CI 44.46–45.16] vs 46.59 [46.39–46.79] years), and predominantly female (79.4% [78.31–80.41] vs 69.6% [68.98–70.14]). Obesity was associated with a longer length of stay in obese patients (4.82 ± 0.09 days) compared with non-obese (4.61 ± 0.05 days; p=0.02). In-hospital mortality difference was insignificant, albeit numerically lower in obese (0.17%, 95% CI 0.09–0.32) than in non-obese patients (0.24%, 95% CI 0.19–0.31; p=0.09). Mean total hospital charges were marginally higher in obese MS exacerbation admissions ($67,890 ± 1,530) than in non-obese ($65,440 ± 1,280; p=0.04). Disposition differed among the groups: discharge to home occurred in 59.9% of obese vs. 59.3% of non-obese patients, while transfer to skilled nursing/ rehabilitation facilities was 18.9% for obese and 20.0% for non-obese.
Conclusions:
Obese patients had higher comorbidity burden and slightly longer LOS, but comparable mortality and similar discharge patterns. Obese patients were younger and predominantly female.
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