Outcomes of Multiple Sclerosis Patients following Admission for Acute Ischemic Stroke in the United States
Sailaja Sanikommu1, Shaheen Sombans2, Kamleshun Ramphul3, Renuka Verma4, Yogeshwaree Ramphul5, Petras Jairam Das Lohana6, Indu Meena3, Komal Kumari7, Stephanie Gonzalez Mejias3, Nomesh Kumar8, Fnu Arti9
1Independent Researcher & Sri Manakula Vinayagar Med College and Hosp, 2Bharati Vidyapeeth University Medical College and Hospital, Pune, India, 3Independent Researcher, 4Independent researcher, 5SSRN Hospital, 6Jacobi Medical Center, 7LUMHS Jamshoro, 8Detroit Medical Center, 9Medstar Union Memorial Hospital
Objective:
To understand the characteristics of Multiple Sclerosis (MS) patients admitted for Acute Ischemic Stroke (AIS) and any differences in outcomes.
Background:
While MS can influence various pathways in the body, there is a lack of research on the impact the disease has on outcomes following an AIS.
Design/Methods:
The 2019 National Inpatient Sample (NIS) was queried to explore the characteristics and outcomes of MS patients admitted for AIS.
Results:
Our study found 2100 (0.4%) AIS patients who also had a diagnosis of MS. More MS patients were females (70.2%), while non-MS patients were more likely to be males (50.8%) (p<0.05). Both groups comprised a higher proportion of patients classified as White (75.4% among MS cases and 67.9% among non-MS cases, p<0.05). MS patients also had a lower prevalence of old myocardial infarct (6.4% vs. 7.5%), but it was not statistically significant (p=0.066). We also found that MS patients were less likely to be diabetic (34.4% vs. 39.3%), hypertensive (77.4% vs. 86.1%), and hyperlipidemia (55.7% vs. 60.8%) compared to non-MS cases of AIS. However, more MS patients with AIS had a smoking history (44.5% vs. 40.1%) and cannabis use (2.4% vs. 1.6%).
Finally, we also found that the MS cases were younger, with a mean age of 62.89 years vs. 69.97 years, had a shorter stay of 4.91 days vs. 5.04 days, and a lower mean hospital charge ($67,201 vs. $71,186). During their stay, 1.9% of MS patients admitted with AIS died (vs. 3.7% in non-MS cases). After adjusting for multiple confounders, the adjusted odds ratio of death among MS patients with AIS compared to non-MS patients was 0.555 (95% confidence interval 0.405-0.760, p<0.05).
Conclusions:
MS patients admitted with AIS have a lower mortality risk than non-MS cases. This can be related to the differences seen in age and multiple comorbidities.