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Abstract Details

The Multiple Sclerosis Comorbidity Index as a Tool for EDSS Prediction: Comparison to the Charlson Comorbidity Index and Elixhauser Comorbidity Measure
Multiple Sclerosis
P15 - Poster Session 15 (12:00 PM-1:00 PM)
9-019
To develop an MS-specific Comorbidity Index (MSCI) for predicting baseline functional status in MS patients upon initial presentation to a tertiary referral center.
Multiple comorbidities are associated with poorer functional status, higher disability progression, and lower life expectancy in MS patients. Predicting functional status of MS patients early in their disease course may help guide patient management.

A consecutive sample of MS patients from a tertiary referral center between 2016-2018 was included in this study. Patient sociodemographic factors (age, sex, gender, insurance status), comorbidities, and Extended Disability Status Scale (EDSS) were collected upon initial presentation. Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Measure (EHM) were calculated. Initial EDSS was adjusted for age and disease duration. Comorbidities and sociodemographic factors were included in a multivariate linear regression model with variable selection using Aikake information criterion to determine their association with initial EDSS. Regression coefficients (B) were rounded to the nearest integer and summed to calculate MSCI scores. R-squared was used to evaluate the association of MSCI, CCI, and EHM with initial EDSS.
Our cohort included 111 patients with a mean age of 47.8 (+/- 13.1). Median MSCI, CCI, and EHM scores were 2, 0, and 2, respectively. MSCI included type 2 diabetes (B=3,p<0.05), hypertension (B=-2,p<0.05), other neurological disease (B=2,p<0.05), depression (B=1,p<0.05), active smoking (B=1,p=0.10), public insurance (B=3,p<0.001), African American race (B=1,p=0.24), and other race (B=2,p=0.093). Patients with higher MSCI had higher adjusted initial EDSS (R2=0.35,p<0.001), but patients with higher CCI (R2=0.011,p=0.28) and EHM (R2=0.012,p=0.27) did not.
Within our cohort, MS patients with higher MSCI had poorer functional baseline upon initial presentation to a tertiary referral center, but those with higher CCI and EHM did not. Further research is needed to validate this scale and evaluate its utility in predicting EDSS changes over time.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
Farren Briggs, PhD (University of Miami Miller School of Medicine) The institution of Prof. Briggs has received research support from NIH.
Faisal A. Alsallom, MD (King Fahad Medical City) Dr. Alsallom has nothing to disclose.
No disclosure on file
Sophia Woodson No disclosure on file
Alessandro Serra, MD (University Hospitals Cleveland Medical Center) Dr. Serra has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen Idec. Dr. Serra has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb.
Hesham A. Abboud, MD (University Hospitals Cleveland Medical Center) Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech . Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpine Pharma. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cycle Pharma. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axonics. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BMS. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TG Therapeutics. The institution of Dr. Abboud has received research support from Genentech . The institution of Dr. Abboud has received research support from Novartis. The institution of Dr. Abboud has received research support from BMS. The institution of Dr. Abboud has received research support from Sanofi-Genzyme. The institution of Dr. Abboud has received research support from The Guthy-Jackson Charitable Foundation. The institution of Dr. Abboud has received research support from UCB. Dr. Abboud has received publishing royalties from a publication relating to health care.