Highlights
- •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.
Abstract
Background
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.
Methods
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.
Results
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.
Conclusion
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.
Keywords
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Article info
Publication history
Published online: July 11, 2020
Accepted:
July 11,
2020
Received in revised form:
July 6,
2020
Received:
February 4,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
