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Abstract Details

Determinants of Mortality Among Hospitalized Patients with Amyotrophic Lateral Sclerosis – Results from the 2016 National Inpatient Sample
Neuromuscular and Clinical Neurophysiology (EMG)
P4 - Poster Session 4 (5:30 PM-6:30 PM)
12-017
To identify the main reasons for hospitalization of patients with amyotrophic lateral sclerosis (ALS) and how these impact inpatient mortality in current practice.
The progressive nature of ALS leads to increasingly intensive patient care, including hospitalization for life threatening disease-related events.
The study population was comprised of 2,442 ALS patients (ICD-10-CM 'G12.21') aged 18-90 years, drawn from the 2016 National Inpatient Sample (NIS), an administrative database representing a 20% stratified sample of hospitalizations from 4,576 participating U.S. hospitals. Multivariate logistic regression analyses were conducted to identify and weight the main determinants of in-patient mortality. The candidate regression model was derived from the most frequent principal admissions diagnoses coincident with ALS, including age and gender.
The mean age of the sample was 64.8+12.5 years, and 41.3% were female. The in-hospital mortality rate was 9.8% (n=239). The most frequent (>1%), principal diagnoses were ALS (18.2%), sepsis (13.4%), respiratory failure (10.1%), pneumonitis due to inhalation (aspiration pneumonia) (6.3%), pneumonia (4.0%), pulmonary embolism (1.6%), and UTI (1.6%). In the multivariate analysis, age (adj OR: 1.02 [95%CI: 1.01-1.03], p=.001), ALS (adj OR: 2.62 [95%CI: 1.75-3.92], p=<.0001), sepsis (adj OR: 4.20 [95%CI: 2.81-6.28], p<.0001), respiratory failure (adj OR: 5.31 [95%CI: 3.50-8.08], p<.0001), and aspiration pneumonia (adj OR: 3.05 [95%CI: 1.78-5.23], p=<.0001) were all significantly associated with increasing mortality.

In patients with ALS, respiratory and infectious complications were the most common reasons for hospital admissions and were the main determinants of inpatient mortality. The 2016 in-hospital mortality rate is reduced relative to an earlier study (14.6%) of the 2002 NIS (Dubinsky et al, Neurology. 2006;67:777–80.). Overall mortality rates appear to have improved over the last 14 years, possibly reflective of better patient care.
Authors/Disclosures
Gilbert J. L'Italien
PRESENTER 		Gilbert J. L'Italien has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Gilbert J. L'Italien has stock in biohaven pharmaceuticals.
Irfan Qureshi, MD (Biohaven Pharmaceuticals) Dr. Qureshi has received personal compensation for serving as an employee of Biohaven. Dr. Qureshi has stock in Biohaven Pharmaceuticals.
Brendan Clark No disclosure on file
Zachary Simmons, MD, FAAN (Penn State Hershey Med Center) Dr. Simmons has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amylyx. Dr. Simmons has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clene. Dr. Simmons has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Insmed. Dr. Simmons has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Simmons has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Corcept. The institution of Dr. Simmons has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. The institution of Dr. Simmons has received research support from MGH. The institution of Dr. Simmons has received research support from Clene. The institution of Dr. Simmons has received research support from NIH via MGH. The institution of Dr. Simmons has received research support from Aburo. The institution of Dr. Simmons has received research support from NIH subaward via Univ of Pennsylvania.