| Abstrakt: |
BACKGROUND: Hospital admissions are costly and put veterans at risk for hospital-acquired diseases. Recent evidence suggests people with multiple sclerosis (MS) are admitted into hospitals at a younger age and stay longer than their age-matched peers (Asemota AO, Schneider EB, Mowry EM, Venkatesan A. Common comorbid and secondary conditions leading to hospitalization in multiple sclerosis patients in the United States. Clin Neurol Neurosurg. 2023;232:107851. doi:10.1016/j.clineuro.2023.107851). OBJECTIVES: To collect data on veterans with MS who are seen at VA Puget Sound in order to identify who is at risk of hospital admission. In addition, to identify issues the outpatient MS clinic can address to decrease hospital admissions for our patients with MS. METHODS: A computer program was made to identify all patients with MS who were admitted to VA Puget Sound. This was queried on a daily basis and data were collected on the age, sex, Expanded Disability Status Scale (EDSS) score, reason for admission, length of stay, and discharge venue. RESULTS: A total of 48 admissions were recorded over an 11-month period from November 18, 2022, to October 18, 2023. These admissions included 31 unique patients. Their average age was 68 (range 42-82); 70% were male and 30% were female. Average EDSS was 7 (range 3-9). Reasons for admissions were infections (31%), medical management of a non--MS-related medical issue (30%), planned admissions for surgical procedures (16%), failure to thrive (8%), spasticity management (6%), neurologic diagnosis (6%), and pain (2%). In the infection group, approximately 60% were related to the urinary tract, 27% were pneumonia, and 13% were skin infections. The average length of stay was 11 days (range 1-75). Fifty-eight percent were discharged back to their home, 30% were discharged to a skilled nursing facility, and 12% were discharged to inpatient rehab prior to returning home. CONCLUSIONS: Of the reasons for admissions, infections, failure to thrive, pain, and spasticity management are potential areas of focus for our outpatient MS clinic. Our next step is to further define the details of these admissions. Our team anticipates that this will lead to clinic changes in equipment, education, and monitoring. [ABSTRACT FROM AUTHOR] |
