Abstract Details

Title Outcomes, Disparities, and Predictors of Meningitis in Multiple Sclerosis Patient Hospitalization

Topic Multiple Sclerosis

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 18-004

Objective To evaluate prevalence, outcomes (mortality, resource utilization), and predictors of concurrent meningitis in a nationally representative MS hospitalization sample.

Background CNS infection outcomes are worse in Multiple sclerosis patients. There is limited data at national level to study outcomes of meningitis in patient with diagnosis of multiple sclerosis. The goal of this study is to identify characteristics and outcomes of meningitis in multiple sclerosis patient

Design/Methods A retrospective cohort study using a NIS identified adult MS hospitalizations with/without concurrent meningitis Survey-weighted multivariable models assessed independent predictors of meningitis and associations with mortality, length of stay, and total charges after adjusting for patient and hospital characteristics.

Results Among 1,054,115 survey-weighted MS hospitalizations (2016-2022), meningitis occurred in 0.16% (n=1,730). Meningitis patients were younger (51.8 vs 57.2 years, p<0.001) with lower comorbidity burden (0.87 vs 1.06, p<0.001). After adjustment, meningitis was associated with significantly longer LOS (10.36 vs 5.56 days; difference +4.80 days, 95% CI 3.29-6.31, p<0.001) and 98% higher charges ($117,133 vs $59,182; ratio 1.98, 95% CI 1.71-2.29, p<0.001). Overall adjusted mortality did not differ significantly (aOR 1.67, 95% CI 0.82-3.41, p=0.157), with predicted mortality 3.08% vs 1.88%. However, bacterial meningitis showed four-fold higher mortality (aOR 4.15, 95% CI 1.47-11.69, p=0.007; adjusted probability 7.16% vs 1.88%). No deaths occurred among viral meningitis cases. Independent predictors of meningitis included younger age (aOR 0.981 per year, p<0.001), ED involvement (aOR 1.47, 95% CI 1.10-1.97), and private insurance versus Medicare (aOR 1.77, 95% CI 1.33-2.36). Highest-income ZIP quartile showed lower odds (Q4 vs Q1: aOR 0.69, 95% CI 0.49-0.96). Viral meningitis was associated with younger age (RRR 0.97 per year, 95% CI 0.96-0.99), private insurance (RRR2.06, 95% CI 1.20-3.53), and trauma center ED admission (RRR2.93, 95% CI 1.45-5.91).

Conclusions

Meningitis in MS patients, though rare, significantly increases healthcare utilization with doubled charges and five additional hospitalization days.

Authors/Disclosures
Muhammad Tayyab Muzaffar Chaychi, MD PRESENTER	Muhammad Tayyab Muzaffar Chaychi, MD has nothing to disclose.
Hafiz M. Maaz (Quaid-e-Azam Medical College, Bahawalpur Pakistan)	Mr. Maaz has nothing to disclose.
Rawdah Shakil, MBBS	Ms. Shakil has nothing to disclose.
Muhammad Sohaib, MBBS	Mr. Sohaib has nothing to disclose.
Muhammad Ahmed, MD (Medical College of Georgia, Augusta University)	Dr. Ahmed has nothing to disclose.

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