Abstract Details

Title Disparities and Outcomes in Multiple Sclerosis Hospitalizations Complicated by Substance Use Disorder: A Seven-year Nationwide Analysis

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 18-004

Objective To examine the prevalence, predictors, and outcomes associated with SUD in hospitalized MS patients using a nationally representative sample.

Background Recreation Substance use is prevalent among multiple sclerosis patients but its impact on hospitalization during exacerbation of Multiple sclerosis episodes remains poorly defined on a national scale.

Design/Methods A retrospective, cross-sectional analysis of the National Inpatient Sample from 2016-2022 was conducted to identify all adult hospitalizations with a principal or secondary diagnosis of MS. SUD was identified using ICD-10-CM codes. Survey-weighted multivariable logistic, gamma, and multinomial regression models were used to adjust for patient, hospital characteristics and outcomes.

Results <p break-words"="">Among 1,054,115 weighted MS hospitalizations (2016–2022), SUD prevalence was 9.3%, driven primarily by alcohol (2.6%), opioids (2.6%), and cannabis (2.6%); opioid poisoning affected 14.1% of the SUD cohort. Patients with SUD were younger (mean 51.4 vs. 57.8 years) and more likely male (aOR: 1.41), with Medicaid insurance (aOR: 1.62), Black race (aOR: 0.64), Hispanic ethnicity (aOR: 0.57), and low-income ZIP codes (aOR: 0.76). Age inversely predicted SUD (aOR for 80+ vs. 18–49: 0.14). After multivariable adjustment, SUD showed no association with in-hospital mortality (aOR: 0.92, 95%CI: 0.80–1.04), though a significant year interaction (p=0.023) revealed lower mortality during 2018–2020 (aOR: 0.65–0.78) and null effects post-2021. SUD independently predicted 10% longer length of stay (6.06 vs. 5.52 days; aGMR: 1.10, 95%CI: 1.08–1.12) but no significant increase in total charges ($60,434 vs. $59,169; p=0.071). Discharge disposition differed markedly: SUD patients had 174% higher risk of leaving against medical advice (3.0% vs. 1.0%; aRRR: 2.74, 95%CI: 2.50–3.00) and reduced likelihood of discharge to skilled nursing facilities (aRRR: 0.72, 95%CI: 0.69–0.76) or with home health care (aRRR: 0.74, 95%CI: 0.71–0.78).

Conclusions Despite comparable mortality, SUD among MS patients prolongs hospitalization and dramatically increases against-medical-advice discharges, underscoring urgent needs for integrated addiction services and discharge psychosocial support.

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

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