Article Type
Changed
Display Headline
Most In-Hospital Deaths in a US MS Population Are MS-Related

Among a sample of 12,386,144 hospitalized patients, those with MS were over 10 years younger than those with diabetes or from the general hospitalized population, on average, when they experienced in-hospital death.

MONTREAL—On average, patients with MS are over 10 years younger than  patients with diabetes mellitus (DM) and patients in the general hospitalized population (GHP) when they experience in-hospital death, researchers reported at 25th Annual Meeting of the Consortium of Multiple Sclerosis Centers.

Frank R. Ernst, PharmD, MS, of Premier Healthcare Alliance, Charlotte, North Carolina, and colleagues noted a paucity of research on mortality and the comorbidities that contribute to it in patients with MS. To investigate these issues, they used a database of information from 600 US hospitals collected over a three-year period to gather data on 12,386,144 patients—110,045 with MS, 4,013,483 with DM, and 8,262,616 from the GHP (who had neither MS nor DM). Then they compared diagnoses, covariates, and comorbidities among the three patient groups.

The patients with MS had the lowest unadjusted gross mortality rate, with in-hospital deaths occurring in 1,336 (1.2%) of these patients, compared with 123,322 (3.1%) patients with DM and 247,799 (3.0%) in GHP patients. The lower MS morality rate is “a possible consequence of restricting the analysis to in-hospital deaths and to lack of adjustments for other covariates,” according to the researchers.

The mean ages at hospital admission were 50.3 in the MS group, 63.1 in the DM group, and 54.3 in the GHP group. The mean ages at in-hospital death were 62.8, 72.9, and 73.1 in the MS, DM, and GHP groups, respectively. The “significantly 10-year lower mean age at death for MS versus DM or GHP… may be related to the significantly earlier mean age at admission,” the researchers suggested.

The most common principal diagnosis associated with death in all three groups was septicemia/sepsis/shock, which accounted for 30%, 18.5%, and 16.4% of deaths in the MS, DM, and GHP groups, respectively. The percentages of deaths in the MS, DM, and GHP accounted for by all eight of the primary diagnosis categories identified by the researchers are shown in the Table.

Percentage of Deaths Within Patient Groups Accounted for by Principle Diagnosis

Principle diagnosis associated with
in-hospital death
Multiple sclerosis group Diabetes mellitus group General hospitalized population group
Sepsis/septicemia/septic shock 30% 18.5% 16.4%
Pulmonary/upper respiratory infection 21.4% 17.5% 18.2%
Cardiovascular/stroke 15.7% 30.6% 23.8%
Other diagnosis 15.0% 19.0% 19.0%
Cancer 6.1% 7.1% 12.5%
Accident/suicide 6.0% 6.1% 8.3%
Multiple sclerosis 4.6% 0% 0%
Other infection 1.1% 1.3% 1.9%

“While the majority of patients were not treated directly for MS, the hospital care received was a likely consequence of underlying MS in many,” the researchers concluded. “This may explain the lower proportion of deaths with principal diagnoses associated with MS … relative to previous studies, which used different ascertainment methods.”

—Jack Baney

References

Suggested Reading
Grytten Torkildsen N, Lie SA, Aarseth JH, et al. Survival and cause of death in multiple sclerosis: results from a 50-year follow-up in Western Norway. Mult Scler. 2008;14(9):1191-1198.
Ragonese P, Aridon P, Mazzola MA, et al. Multiple sclerosis survival: a population-based study in Sicily. Eur J Neurol. 2010;17(3):391-397.
Smestad C, Sandvik L, Celius EG. Excess mortality and cause of death in a cohort of Norwegian multiple sclerosis patients. Mult Scler. 2009;15(11):1263-1270.

Author and Disclosure Information

Issue
Neurology Reviews - 19(10)
Publications
Topics
Page Number
19
Legacy Keywords
neurology reviews, Most In-Hospital Deaths in a US MS Population Are MS-Related, multiple sclerosis, diabetes, mortality, in-hospital deaths, frank ernst, premier healthcare alliance, consortium of multiple sclerosis centers, ms mortality, jack baneyneurology reviews, Most In-Hospital Deaths in a US MS Population Are MS-Related, multiple sclerosis, diabetes, mortality, in-hospital deaths, frank ernst, premier healthcare alliance, consortium of multiple sclerosis centers, ms mortality, jack baney
Author and Disclosure Information

Author and Disclosure Information

Among a sample of 12,386,144 hospitalized patients, those with MS were over 10 years younger than those with diabetes or from the general hospitalized population, on average, when they experienced in-hospital death.

MONTREAL—On average, patients with MS are over 10 years younger than  patients with diabetes mellitus (DM) and patients in the general hospitalized population (GHP) when they experience in-hospital death, researchers reported at 25th Annual Meeting of the Consortium of Multiple Sclerosis Centers.

Frank R. Ernst, PharmD, MS, of Premier Healthcare Alliance, Charlotte, North Carolina, and colleagues noted a paucity of research on mortality and the comorbidities that contribute to it in patients with MS. To investigate these issues, they used a database of information from 600 US hospitals collected over a three-year period to gather data on 12,386,144 patients—110,045 with MS, 4,013,483 with DM, and 8,262,616 from the GHP (who had neither MS nor DM). Then they compared diagnoses, covariates, and comorbidities among the three patient groups.

The patients with MS had the lowest unadjusted gross mortality rate, with in-hospital deaths occurring in 1,336 (1.2%) of these patients, compared with 123,322 (3.1%) patients with DM and 247,799 (3.0%) in GHP patients. The lower MS morality rate is “a possible consequence of restricting the analysis to in-hospital deaths and to lack of adjustments for other covariates,” according to the researchers.

The mean ages at hospital admission were 50.3 in the MS group, 63.1 in the DM group, and 54.3 in the GHP group. The mean ages at in-hospital death were 62.8, 72.9, and 73.1 in the MS, DM, and GHP groups, respectively. The “significantly 10-year lower mean age at death for MS versus DM or GHP… may be related to the significantly earlier mean age at admission,” the researchers suggested.

The most common principal diagnosis associated with death in all three groups was septicemia/sepsis/shock, which accounted for 30%, 18.5%, and 16.4% of deaths in the MS, DM, and GHP groups, respectively. The percentages of deaths in the MS, DM, and GHP accounted for by all eight of the primary diagnosis categories identified by the researchers are shown in the Table.

Percentage of Deaths Within Patient Groups Accounted for by Principle Diagnosis

Principle diagnosis associated with
in-hospital death
Multiple sclerosis group Diabetes mellitus group General hospitalized population group
Sepsis/septicemia/septic shock 30% 18.5% 16.4%
Pulmonary/upper respiratory infection 21.4% 17.5% 18.2%
Cardiovascular/stroke 15.7% 30.6% 23.8%
Other diagnosis 15.0% 19.0% 19.0%
Cancer 6.1% 7.1% 12.5%
Accident/suicide 6.0% 6.1% 8.3%
Multiple sclerosis 4.6% 0% 0%
Other infection 1.1% 1.3% 1.9%

“While the majority of patients were not treated directly for MS, the hospital care received was a likely consequence of underlying MS in many,” the researchers concluded. “This may explain the lower proportion of deaths with principal diagnoses associated with MS … relative to previous studies, which used different ascertainment methods.”

—Jack Baney

Among a sample of 12,386,144 hospitalized patients, those with MS were over 10 years younger than those with diabetes or from the general hospitalized population, on average, when they experienced in-hospital death.

MONTREAL—On average, patients with MS are over 10 years younger than  patients with diabetes mellitus (DM) and patients in the general hospitalized population (GHP) when they experience in-hospital death, researchers reported at 25th Annual Meeting of the Consortium of Multiple Sclerosis Centers.

Frank R. Ernst, PharmD, MS, of Premier Healthcare Alliance, Charlotte, North Carolina, and colleagues noted a paucity of research on mortality and the comorbidities that contribute to it in patients with MS. To investigate these issues, they used a database of information from 600 US hospitals collected over a three-year period to gather data on 12,386,144 patients—110,045 with MS, 4,013,483 with DM, and 8,262,616 from the GHP (who had neither MS nor DM). Then they compared diagnoses, covariates, and comorbidities among the three patient groups.

The patients with MS had the lowest unadjusted gross mortality rate, with in-hospital deaths occurring in 1,336 (1.2%) of these patients, compared with 123,322 (3.1%) patients with DM and 247,799 (3.0%) in GHP patients. The lower MS morality rate is “a possible consequence of restricting the analysis to in-hospital deaths and to lack of adjustments for other covariates,” according to the researchers.

The mean ages at hospital admission were 50.3 in the MS group, 63.1 in the DM group, and 54.3 in the GHP group. The mean ages at in-hospital death were 62.8, 72.9, and 73.1 in the MS, DM, and GHP groups, respectively. The “significantly 10-year lower mean age at death for MS versus DM or GHP… may be related to the significantly earlier mean age at admission,” the researchers suggested.

The most common principal diagnosis associated with death in all three groups was septicemia/sepsis/shock, which accounted for 30%, 18.5%, and 16.4% of deaths in the MS, DM, and GHP groups, respectively. The percentages of deaths in the MS, DM, and GHP accounted for by all eight of the primary diagnosis categories identified by the researchers are shown in the Table.

Percentage of Deaths Within Patient Groups Accounted for by Principle Diagnosis

Principle diagnosis associated with
in-hospital death
Multiple sclerosis group Diabetes mellitus group General hospitalized population group
Sepsis/septicemia/septic shock 30% 18.5% 16.4%
Pulmonary/upper respiratory infection 21.4% 17.5% 18.2%
Cardiovascular/stroke 15.7% 30.6% 23.8%
Other diagnosis 15.0% 19.0% 19.0%
Cancer 6.1% 7.1% 12.5%
Accident/suicide 6.0% 6.1% 8.3%
Multiple sclerosis 4.6% 0% 0%
Other infection 1.1% 1.3% 1.9%

“While the majority of patients were not treated directly for MS, the hospital care received was a likely consequence of underlying MS in many,” the researchers concluded. “This may explain the lower proportion of deaths with principal diagnoses associated with MS … relative to previous studies, which used different ascertainment methods.”

—Jack Baney

References

Suggested Reading
Grytten Torkildsen N, Lie SA, Aarseth JH, et al. Survival and cause of death in multiple sclerosis: results from a 50-year follow-up in Western Norway. Mult Scler. 2008;14(9):1191-1198.
Ragonese P, Aridon P, Mazzola MA, et al. Multiple sclerosis survival: a population-based study in Sicily. Eur J Neurol. 2010;17(3):391-397.
Smestad C, Sandvik L, Celius EG. Excess mortality and cause of death in a cohort of Norwegian multiple sclerosis patients. Mult Scler. 2009;15(11):1263-1270.

References

Suggested Reading
Grytten Torkildsen N, Lie SA, Aarseth JH, et al. Survival and cause of death in multiple sclerosis: results from a 50-year follow-up in Western Norway. Mult Scler. 2008;14(9):1191-1198.
Ragonese P, Aridon P, Mazzola MA, et al. Multiple sclerosis survival: a population-based study in Sicily. Eur J Neurol. 2010;17(3):391-397.
Smestad C, Sandvik L, Celius EG. Excess mortality and cause of death in a cohort of Norwegian multiple sclerosis patients. Mult Scler. 2009;15(11):1263-1270.

Issue
Neurology Reviews - 19(10)
Issue
Neurology Reviews - 19(10)
Page Number
19
Page Number
19
Publications
Publications
Topics
Article Type
Display Headline
Most In-Hospital Deaths in a US MS Population Are MS-Related
Display Headline
Most In-Hospital Deaths in a US MS Population Are MS-Related
Legacy Keywords
neurology reviews, Most In-Hospital Deaths in a US MS Population Are MS-Related, multiple sclerosis, diabetes, mortality, in-hospital deaths, frank ernst, premier healthcare alliance, consortium of multiple sclerosis centers, ms mortality, jack baneyneurology reviews, Most In-Hospital Deaths in a US MS Population Are MS-Related, multiple sclerosis, diabetes, mortality, in-hospital deaths, frank ernst, premier healthcare alliance, consortium of multiple sclerosis centers, ms mortality, jack baney
Legacy Keywords
neurology reviews, Most In-Hospital Deaths in a US MS Population Are MS-Related, multiple sclerosis, diabetes, mortality, in-hospital deaths, frank ernst, premier healthcare alliance, consortium of multiple sclerosis centers, ms mortality, jack baneyneurology reviews, Most In-Hospital Deaths in a US MS Population Are MS-Related, multiple sclerosis, diabetes, mortality, in-hospital deaths, frank ernst, premier healthcare alliance, consortium of multiple sclerosis centers, ms mortality, jack baney
Article Source

PURLs Copyright

Inside the Article