NEW ORLEANS—Patients with multiple sclerosis (MS) had increased rates of in-hospital mortality and discharge to nursing facilities, compared with patients with MS plus a coexisting autoimmune disorder, according to research presented at the 31st Annual Meeting of the Consortium of MS Centers.
Malik M. Adil, MD
“The findings in this study suggest that a coexisting autoimmune disorder may in fact lessen the severity of the immune dysregulation of MS, which leads to improved health outcomes,” said Malik M. Adil, MD, a neurology resident at the Ochsner Clinic Foundation in New Orleans, and colleagues.
Studies have suggested an association between MS and autoimmune disorders, but research concerning clinical outcomes is limited. To determine whether coexisting autoimmune disorders affect outcomes in patients with MS, Dr. Adil and colleagues analyzed Nationwide Inpatient Survey data files from 2006 to 2010. The researchers classified patients with MS into two groups: an MS group (without coexisting autoimmune disorders) and an MS Plus group (with coexisting autoimmune disorders).
The investigators then compared the rate of clinical outcomes (ie, in-hospital mortality, discharge to home, discharge to nursing facilities, length of stay, and total charges) between the MS and MS Plus groups. Dr. Adil and colleagues used multivariate analysis to adjust for potential confounders when assessing in-hospital outcomes.
Of 115,120 patients with MS, 18,796 were in the MS Plus group. The adjusted odds of in-hospital mortality and of discharge to nursing facilities were significantly higher in the MS group, compared with the MS Plus group (odds ratios, 4.67 and 1.16, respectively). Length of stay and mean hospital charges were significantly higher in the MS Plus group, compared with the MS group.
A possible explanation for the findings is that coexisting autoimmune diseases involve different effector T cells that may regulate the effect of other effector T cells, said the authors. “Other possible explanations of better outcome in the MS Plus group might be the use of chronic immune suppressive agents in addition to MS immunotherapy, and multidisciplinary management,” they added.