Among a sample of 12,386,144 hospitalized patients, those with MS were over 10 years younger than those with diabetes or from the general hospitalized population, on average, when they experienced in-hospital death.
MONTREAL—On average, patients with MS are over 10 years younger than patients with diabetes mellitus (DM) and patients in the general hospitalized population (GHP) when they experience in-hospital death, researchers reported at 25th Annual Meeting of the Consortium of Multiple Sclerosis Centers.
Frank R. Ernst, PharmD, MS, of Premier Healthcare Alliance, Charlotte, North Carolina, and colleagues noted a paucity of research on mortality and the comorbidities that contribute to it in patients with MS. To investigate these issues, they used a database of information from 600 US hospitals collected over a three-year period to gather data on 12,386,144 patients—110,045 with MS, 4,013,483 with DM, and 8,262,616 from the GHP (who had neither MS nor DM). Then they compared diagnoses, covariates, and comorbidities among the three patient groups.
The patients with MS had the lowest unadjusted gross mortality rate, with in-hospital deaths occurring in 1,336 (1.2%) of these patients, compared with 123,322 (3.1%) patients with DM and 247,799 (3.0%) in GHP patients. The lower MS morality rate is “a possible consequence of restricting the analysis to in-hospital deaths and to lack of adjustments for other covariates,” according to the researchers.
The mean ages at hospital admission were 50.3 in the MS group, 63.1 in the DM group, and 54.3 in the GHP group. The mean ages at in-hospital death were 62.8, 72.9, and 73.1 in the MS, DM, and GHP groups, respectively. The “significantly 10-year lower mean age at death for MS versus DM or GHP… may be related to the significantly earlier mean age at admission,” the researchers suggested.
The most common principal diagnosis associated with death in all three groups was septicemia/sepsis/shock, which accounted for 30%, 18.5%, and 16.4% of deaths in the MS, DM, and GHP groups, respectively. The percentages of deaths in the MS, DM, and GHP accounted for by all eight of the primary diagnosis categories identified by the researchers are shown in the Table.
Percentage of Deaths Within Patient Groups Accounted for by Principle Diagnosis
| Principle diagnosis associated with in-hospital death | Multiple sclerosis group | Diabetes mellitus group | General hospitalized population group |
| Sepsis/septicemia/septic shock | 30% | 18.5% | 16.4% |
| Pulmonary/upper respiratory infection | 21.4% | 17.5% | 18.2% |
| Cardiovascular/stroke | 15.7% | 30.6% | 23.8% |
| Other diagnosis | 15.0% | 19.0% | 19.0% |
| Cancer | 6.1% | 7.1% | 12.5% |
| Accident/suicide | 6.0% | 6.1% | 8.3% |
| Multiple sclerosis | 4.6% | 0% | 0% |
| Other infection | 1.1% | 1.3% | 1.9% |
“While the majority of patients were not treated directly for MS, the hospital care received was a likely consequence of underlying MS in many,” the researchers concluded. “This may explain the lower proportion of deaths with principal diagnoses associated with MS … relative to previous studies, which used different ascertainment methods.”
—Jack Baney