Research Article| Volume 45, 102396, October 2020

Trends in hospital readmissions in Multiple Sclerosis patients between 2009 and 2015


      • Hospitalizations are an important component of health resource use and there is a need to address readmission rates in Multiple Sclerosis patients.
      • Common medical comorbidities such as neurogenic bladder and ischemic heart disease should be prevented, screened and managed in this population.
      • Patients with progressive disease subtypes and those under “second-line drugs” have a higher and soon after discharge risk of hospital readmission.
      • Efforts to reduce hospitalizations will need to be directed at preventing infections and disease-related complications.



      Readmission rate is an important healthcare quality metric and remains a problem in Multiple Sclerosis (MS) patients, nonetheless information about this issue is scarce. We present the first study to estimate hospital readmissions in a MS hospital-based European cohort.


      Retrospective cohort study of patients with at least one hospitalization with a primary discharge of MS from August 1, 2009 and July 31, 2015. The primary outcome was hospitalization within 30 days post-discharge (30-DR). The secondary outcomes included length of stay during index and readmission, total hospital readmissions during the study period, predictors and causes of readmission.


      Forty-four (41.5%) patients had a hospital readmission during the six years of this study, 11.3% of them 30-DR, mainly due to infections (58.5%). The two most common comorbidities in these patients were neurogenic bladder (47.7%) and ischemic heart disease (18.1%). Progressive MS subtype was the main predictor of 30-DR, even after adjustment for therapy (OR: 6.29; p = 0.016), with an area under the curve of 0.73.


      Progressive MS subtypes and “second-line drugs” carry a higher risk of hospital readmission soon after discharge. The impact and cost-effectiveness of strategies to lower readmission rates in MS should be the focus of upcoming studies.


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