Multiple Sclerosis in the Emergency Department

BACKGROUND AND OBJECTIVES: The reasons for people with multiple sclerosis (MS) to access emergency services are understudied in the era of high-efficacy disease-modifying therapies (DMTs). Many people with MS live with multiple comorbidities and/or experience social determinants of health, which may affect their emergency department (ED) use. The aim of this study was to identify the reasons and risk factors for ED visits among patients with known MS, including sociodemographic characteristics, comorbidity burden, and DMT efficacy category. METHODS: A retrospective case-control study was conducted at the Massachusetts General Hospital, Boston. Patients with MS were analyzed in a 1:2 ratio of cases (patients with at least one ED visit) and controls (no ED visits) during the study time frame June 2019-December 2023. Regression models were constructed to assess the association of predefined variables-sex, age, race, insurance type, comorbidities as a Charlson Comorbidity Index (CCI), and DMT efficacy category-with the likelihood of an ED visit. RESULTS: = 0.006). DISCUSSION: Specific risk factors for ED use occur in people with known MS. Comprehensive management of comorbidities and clinical pathways to reassess the high number of people with MS in the ED who do not take a DMT should be considered.