Abstract Details

Title Anomalously warm weather and acute care visits in patients with multiple sclerosis: A retrospective study of privately insured individuals in the U.S.

Topic General Neurology

Presentation(s) S21 - Neuroepidemiology (2:24 PM-2:32 PM)

Poster/Presentation
Number 003

Background Heat sensitivity is a recognized clinical feature of MS a chronic demyelinating disorder of the central nervous system. Periods of anomalously warm weather are expected to become more frequent under climate change, yet few studies have specifically examined the health services implications of weather anomalies for individuals living with MS.

Objective

Quantify the impact of anomalously warm weather for risk of multiple sclerosis (MS) related outpatient, emergency department, and inpatient visits in the United States.

Design/Methods

Retrospective cohort study of individuals with MS aged 18–64 years in a nationwide patient-level commercial and Medicare Advantage claims database. Based on previously validated algorithms, individuals with MS were identified as those with at least three MS-related claims for inpatient, outpatient, or disease-modifying therapy claims within a 365-day period. We defined anomalously warm weather as any month in which local average temperatures exceeded the long-term average temperature for that month by at least 1.5°C. We used generalized log-linear models to estimate the implications of anomalously warm weather for MS-related inpatient, outpatient, and emergency department visits.

Results From 75,395,334 individuals we identified 106,225 with MS (0.14%). The majority were women (76.6%) and aged 36–55 years at baseline (59.0%). In adjusted generalized log-linear models, warm weather anomalies were primarily associated with acute care visits: we found increased risk of emergency department visits (relative risk [RR] = 1.04, 95% CI: 1.03–1.06) and inpatient visits (RR = 1.03, 95% CI 1.01–1.055) related to MS. Effect estimates were similar for men and women, strongest among older individuals, and exhibited substantial regional and seasonal variation.

Conclusions As global temperatures rise, individuals with MS may represent a sub-population uniquely susceptible to associated periods of anomalously warm weather, with implications for both health care providers and systems.

Authors/Disclosures
Holly Elser, MD, PhD (Hospital of the University of Pennsylvania) PRESENTER	Dr. Elser has nothing to disclose.
	No disclosure on file
Nuriel Moghavem, MD (Los Angeles General Medical Center)	Dr. Moghavem has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Multiple Sclerosis Association of America. Dr. Moghavem has a non-compensated relationship as a Committee Member with National Multiple Sclerosis Society that is relevant to AAN interests or activities. Dr. Moghavem has a non-compensated relationship as a Board Member with Los Angeles County Medical Association that is relevant to AAN interests or activities.
	No disclosure on file
Nina Bozinov, MD (Kootenai Health)	Dr. Bozinov has nothing to disclose.
Victor W. Henderson, MD, FAAN	Dr. Henderson has stock in Abbott, Amgen, Roche. The institution of Dr. Henderson has received research support from NIH. The institution of Dr. Henderson has received research support from Health IQ. Dr. Henderson has received personal compensation in the range of $500-$4,999 for serving as a External advisory committee member, Alzheimer's Disease Center with University of Kansas. Dr. Henderson has a non-compensated relationship as a adjunct (honorary) professor with Aarhus University that is relevant to AAN interests or activities.
	No disclosure on file
	No disclosure on file