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Abstract Details

Relapse And Non-relapse Hospitalizations in Neuromyelitis Optica Spectrum Disorders (NMOSD)
Neurohospitalist
P8 - Poster Session 8 (5:30 PM-6:30 PM)
15-004
To determine the characteristics of hospitalizations in a cohort of patients with NMOSD.
Hospitalization in NMOSD may result from relapses, infectious complications, symptom management or other medical complications.
A retrospective analysis of patients diagnosed with NMOSD according to the 2015 criteria at Mass General Brigham hospital system from 2005-2021. Data on demographics, disease course, treatments, and hospitalizations were collected.
127 patients were included; 82.9% were AQP4 seropositive and 81.1% were female. The most common phenotypes at presentation were myelitis (47.9%) and optic neuritis (41.7%). Median follow-up time from diagnosis was 5 years (IQR 2-8). Median length of stay for relapse hospitalizations was 6 days (IQR 4-11). 64.2% of patients received corticosteroids and 19.8% underwent plasma exchange. Relapse hospitalizations had secondary nosocomial complications in 46% of which the most common cause was infection (38%). In univariate negative binomial regression analysis, one-unit increase in mRS score and presence of infections were associated with a 26% (IRR=1.26, 95% CI = [1.12,1.42], p < 0.001) and 75% increase in expected length of stay (IRR=1.75, 95% CI = [1.36, 2.26], p < 0.001). Use of mycophenolate mofetil (MMF) was associated with 4-fold increase in odds of infectious complication during admission (OR=4.05, 95% CI 1.36-12.05, p=0.01). Adjusting for acute treatments and admission mRS, optic neuritis was associated with 39% reduction in expected length of stay (IRR=0.61, 95% CI = [0.48, 0.78], p<0.001). Median length of stay for non-relapse hospitalizations was 5 days (IQR 3-11). The most common reason for non-relapse hospitalization was infection (46%). There were 10 deaths in the cohort; one was NMOSD-related.

NMOSD often necessitates extended hospitalizations for relapses and non-relapses, with infections being frequent complication and a common non-relapse admission cause. Admission mRS and infections predict longer relapse hospitalizations, while MMF usage is associated with increased infection odds during admission.
Authors/Disclosures
Philippe-Antoine Bilodeau, MD (Massachusetts General Hospital)
PRESENTER 		Dr. Bilodeau has nothing to disclose.
Sathya S. Narasimhan, MBBS (Baylor College of Medicine) Dr. Narasimhan has nothing to disclose.
Danielle Kei Pua, MD (Westchester Medical Center) Dr. Pua has nothing to disclose.
Kathryn Holroyd, MD The institution of Dr. Holroyd has received research support from NINDS.
Farrah J. Mateen, MD, PhD, FAAN (Northwestern University Department of Neurology) Dr. Mateen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Mateen has received research support from Genentech. The institution of Dr. Mateen has received research support from Amgen. The institution of Dr. Mateen has received research support from TG Therapeutics. Dr. Mateen has received intellectual property interests from a discovery or technology relating to health care.
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School) Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.
Shamik Bhattacharyya, MD, FAAN (Brigham and Women's Hospital) Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroLambda. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Merck. The institution of Dr. Bhattacharyya has received research support from Alexion Pharmaceuticals. The institution of Dr. Bhattacharyya has received research support from National Institute of Health. The institution of Dr. Bhattacharyya has received research support from UCB. The institution of Dr. Bhattacharyya has received research support from Genentech. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care.