Increased Age, Comorbidities, and Prior Admissions Predict All-Cause Hospitalizations in Patients With MS

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Predictors of all-cause hospitalizations in patients with MS included increased age, presence of a comorbidity, and having a history of hospital admissions.

Predictors of all-cause hospitalizations in patients with multiple sclerosis (MS) included increased age, presence of a comorbidity, and having a history of hospital admissions. This is according to a study in Multiple Sclerosis and Related Disorders.

Population-based health administrative data from Saskatchewan, Canada, between 1996 and 2016 were used in this retrospective cohort study. A total of 4878 people with MS who had either ≥3 hospital, physician, or drug claims for MS were included in the study. The MS group included a total of 11,744 hospitalizations over the observational period.

An additional 23,662 matched controls with 32,541 hospitalizations were included as a comparison group. Potential predictors for hospitalization assessed in this study were sex, age, median household income, calendar year, previous hospitalizations, and comorbidity status.

In the MS cohort, predictors of all-cause hospitalization included having a higher comorbidity burden (≥2; rate ratio [RR], 2.21; 95% CI, 1.84-2.65), older age (≥60 years; RR, 1.67; 95% CI, 1.48-1.88), and previous hospital admissions (RR, 4.11; 95% CI, 3.46-4.87). These same predictors held true for the matched control group.

Compared to women, men had a higher rate of all-cause hospitalizations (adjusted rate ratio, 1.20; 95% CI, 1.07-1.34) as well as higher odds of MS-specific hospitalization (adjusted odds ratio, 1.34; 95% CI, 1.15-1.55). The risk of an MS-specific hospitalization decreased with increasing age, a finding that was in direct contrast to all-cause hospitalizations. Patients with an MS diagnosis had decreased odds of hospitalization related to neoplasms, circulatory system diseases, and mental health and behavioral disorders.

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Limitations of the study included the lack of information on how disease-modifying treatments may have affected hospitalizations as well as the lack of identification of the causes related to the MS-specific hospitalizations.

The researchers emphasized that their findings highlight the variations in causes of hospitalizations “by age, and that clinicians should consider this when managing patients to try to reduce hospitalizations in the MS population.”


Al-Sakran LH, Marrie RA, Blackburn DF, Knox KB, Evans CD. Predictors of hospitalization in a Canadian MS population: A matched cohort study [published online February 27, 2020]. Mult Scler Relat Disord. doi: 10.1016/j.msard.2020.102028.