Stroke Outcomes and Hyperacute Treatment Utilization in Multiple Sclerosis.

Abstract

People with MS (pwMS) have higher prevalence of comorbidities at disease onset and face increased risk of developing cardiovascular disorders. Stroke is of particular concern for this population with previous neurological disability. However, data on stroke outcomes and resource utilization in those pwMS remains scarce. To assess the risk of adverse stroke outcomes and hyperacute treatment utilization for pwMS in a U.S. population-based sample of hospitalized patients. This study identified patients discharged with a diagnosis of ischemic stroke in the 2018 National Inpatient Sample. We compared the discharge outcomes and hyperacute stroke treatment utilization in MS (n=2,795) versus non-MS patients (n=682.730). Regression models adjusted for cardiovascular risk factors and hospital characteristics were used to account for the complex sampling design. The odds of a good discharge were 32% less likely to occur in pwMS (adj.OR 0.68 [95%CI 0.58-0.81], p<0.001). However, this was not associated with an increased risk of mortality. PwMS had a 57% reduction in the risk of receiving endovascular thrombectomy (EVT) (adj.OR 0.43 [95%CI 0.22-0.83], p=0.01) but no difference in rates of thrombolysis. Patients with MS have lowerrates of gooddischarge outcomes and EVT with ischemic stroke, despite similar rates of thrombolysis.