Highlights
- •Children with multiple sclerosis (MS) have more hospitalizations and physician visits than healthy children.
- •Among children with MS, more relapses are associated with increased odds of hospitalization.
- •Better cognitive accuracy scores are associated with fewer physician visits.
Abstract
Background
We assessed whether clinical characteristics and health-related quality of life (HRQOL)
are independently associated with subsequent hospitalizations and physician visits
among children with multiple sclerosis (MS); and whether differences in HRQOL account
for differences in physician visits between children with MS, monophasic acquired
demyelinating syndromes (ADS) and healthy children.
Methods
We used linked administrative (health) data from Ontario, Canada and data from a prospective
cohort study including HRQOL (measured using the PedsQL), age, sex, cognitive function
(accuracy and response time as assessed by Penn Neurocognitive Battery), number of
relapses, and neurologic abnormalities on examination. We used generalized linear
models with generalized estimating equations to examine factors associated with hospitalizations
and ambulatory physician visit rates following each HRQOL assessment, adjusting for
age, sex, and socioeconomic status.
Results
: We included 36 children with MS, 43 with monophasic ADS and 43 healthy controls.
Among children with MS, more relapses were associated with increased odds of hospitalization
(odds ratio 1.59; 1.18–2.14); better cognitive accuracy scores were associated with
fewer physician visits (rate ratio [RR] 0.68; 0.47–0.98). Children with MS had higher
rates of physician visits than healthy children (RR 1.44; 1.00–2.08), unlike children
with a monophasic ADS, but HRQOL scores did not account for these differences.
Conclusion
: Within the MS population, more relapses are associated with increased odds of hospitalization
while better cognitive performance is associated with reduced rates of physician visits.
Differences in HRQOL do not account for differences in physician visits by children
with MS as compared to healthy children.
Keywords
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Article info
Publication history
Published online: November 06, 2019
Accepted:
November 5,
2019
Received in revised form:
November 2,
2019
Received:
June 15,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
