Impact of surgery in patients with multiple sclerosis: a nationwide cohort study
BackgroundSurgery is a common exposure. Multiple sclerosis (MS) is a chronic neuroinflammatory demyelinating disease of the central nervous system and a systemic inflammatory activation caused by surgery may result in exacerbation of the disease. It is unknown how surgical procedures affect morbidit...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1573349/full |
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| author | Emma Larsson Emma Larsson Ellen Iacobaeus Ellen Iacobaeus Erik von Oelreich Erik von Oelreich Jesper Eriksson Jesper Eriksson Jessica Kåhlin Jessica Kåhlin |
| author_facet | Emma Larsson Emma Larsson Ellen Iacobaeus Ellen Iacobaeus Erik von Oelreich Erik von Oelreich Jesper Eriksson Jesper Eriksson Jessica Kåhlin Jessica Kåhlin |
| author_sort | Emma Larsson |
| collection | DOAJ |
| description | BackgroundSurgery is a common exposure. Multiple sclerosis (MS) is a chronic neuroinflammatory demyelinating disease of the central nervous system and a systemic inflammatory activation caused by surgery may result in exacerbation of the disease. It is unknown how surgical procedures affect morbidity and mortality rates in MS.ObjectivesThis study aimed to investigate morbidity associated with surgical interventions in MS patients by assessing disease burden before and after surgery. Non-MS patients were used as controls, allowing for comparisons of disease burden and mortality between the two groups.MethodsThe cohort study analyzed data from the Swedish Perioperative Register, including 3,022 MS patients among over 1.5 million surgeries performed between January 2019 and March 2023. Disease burden was measured as the number of pre-specified ICD-codes before and after surgery.ResultsWe demonstrated that MS patients exhibited a higher mean number of diagnoses before and after surgery compared to controls. Specifically, the number of diagnoses peaked in the first month post-surgery but returned to baseline within three to 4 months. Notably, there were no significant differences in 30-day or 365-day mortality rates between MS and non-MS patients, highlighting the relative safety of surgical interventions for persons with MS.ConclusionThe findings suggest that surgery is generally safe for patients with MS, indicating that MS should not preclude necessary surgical interventions. Nevertheless, tailored preoperative assessments and postoperative care strategies are essential to address the unique health challenges encountered by MS patients, ensuring optimal surgical outcomes and monitoring for potential complications. |
| format | Article |
| id | doaj-art-01183b00d80148edbeaba5bd6acd4edd |
| institution | Matheson Library |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-01183b00d80148edbeaba5bd6acd4edd2025-06-26T04:10:27ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.15733491573349Impact of surgery in patients with multiple sclerosis: a nationwide cohort studyEmma Larsson0Emma Larsson1Ellen Iacobaeus2Ellen Iacobaeus3Erik von Oelreich4Erik von Oelreich5Jesper Eriksson6Jesper Eriksson7Jessica Kåhlin8Jessica Kåhlin9Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, SwedenDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital Solna, Stockholm, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Neurology, Karolinska University Hospital, Stockholm, SwedenDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, SwedenDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital Solna, Stockholm, SwedenDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, SwedenDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital Solna, Stockholm, SwedenDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, SwedenDepartment of Perioperative Medicine and Intensive Care, Karolinska University Hospital Solna, Stockholm, SwedenBackgroundSurgery is a common exposure. Multiple sclerosis (MS) is a chronic neuroinflammatory demyelinating disease of the central nervous system and a systemic inflammatory activation caused by surgery may result in exacerbation of the disease. It is unknown how surgical procedures affect morbidity and mortality rates in MS.ObjectivesThis study aimed to investigate morbidity associated with surgical interventions in MS patients by assessing disease burden before and after surgery. Non-MS patients were used as controls, allowing for comparisons of disease burden and mortality between the two groups.MethodsThe cohort study analyzed data from the Swedish Perioperative Register, including 3,022 MS patients among over 1.5 million surgeries performed between January 2019 and March 2023. Disease burden was measured as the number of pre-specified ICD-codes before and after surgery.ResultsWe demonstrated that MS patients exhibited a higher mean number of diagnoses before and after surgery compared to controls. Specifically, the number of diagnoses peaked in the first month post-surgery but returned to baseline within three to 4 months. Notably, there were no significant differences in 30-day or 365-day mortality rates between MS and non-MS patients, highlighting the relative safety of surgical interventions for persons with MS.ConclusionThe findings suggest that surgery is generally safe for patients with MS, indicating that MS should not preclude necessary surgical interventions. Nevertheless, tailored preoperative assessments and postoperative care strategies are essential to address the unique health challenges encountered by MS patients, ensuring optimal surgical outcomes and monitoring for potential complications.https://www.frontiersin.org/articles/10.3389/fneur.2025.1573349/fullmultiple sclerosissurgeryperioperative carehealth care utilizationpostoperative outcome |
| spellingShingle | Emma Larsson Emma Larsson Ellen Iacobaeus Ellen Iacobaeus Erik von Oelreich Erik von Oelreich Jesper Eriksson Jesper Eriksson Jessica Kåhlin Jessica Kåhlin Impact of surgery in patients with multiple sclerosis: a nationwide cohort study Frontiers in Neurology multiple sclerosis surgery perioperative care health care utilization postoperative outcome |
| title | Impact of surgery in patients with multiple sclerosis: a nationwide cohort study |
| title_full | Impact of surgery in patients with multiple sclerosis: a nationwide cohort study |
| title_fullStr | Impact of surgery in patients with multiple sclerosis: a nationwide cohort study |
| title_full_unstemmed | Impact of surgery in patients with multiple sclerosis: a nationwide cohort study |
| title_short | Impact of surgery in patients with multiple sclerosis: a nationwide cohort study |
| title_sort | impact of surgery in patients with multiple sclerosis a nationwide cohort study |
| topic | multiple sclerosis surgery perioperative care health care utilization postoperative outcome |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1573349/full |
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