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

• Published in: Multiple sclerosis and related disorders 2020-10, Vol.45, p.102396-102396, Article 102396
• Main Authors: Cabreira, Verónica, Abreu, Pedro, Maia, Carolina, Costa, Andreia, Sá, Maria José
• Format: Article
• Language: English
• Subjects: Aftercare; Cost-effectiveness; Healthcare quality; Hospital readmissions; Humans; Length of Stay; Multiple Sclerosis; Multiple Sclerosis - epidemiology; Multiple Sclerosis - therapy; Patient Discharge; Patient Readmission; Retrospective Studies; Risk Factors
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2020.102396

•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.