MS Speaks

I'm not sure how accurately causes of death can be generalized for MS patients based on a study of 10 patients, but these authors conclude that "mortality in critically ill MS patients is largely driven by respiratory complications."

From PubMed, December 24, 2016:

Acta Neurol Scand. 2016 Dec 23.

Causes of death in critically ill multiple sclerosis patients

Karamyan A1, Brandtner H2, Grinzinger S1, Chroust V1, Bacher C1, Otto F1, Reisp M1, Hauer L3, Sellner J1,4.

Author information

1Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
2Department of Forensic Medicine, Paris London University, Salzburg, Austria.
3Department of Psychiatry, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
4Department of Neurology, Klinikum rechts der Isar, Technische Universität München, München, Germany.

BACKGROUND:

Patients with multiple sclerosis (MS) experience higher mortality rates as compared to the general population. While the risk of intensive care unit (ICU) admission is also reported to be higher, little is known about causes of death (CoD) in critically ill MS patients.

AIM:

To study the causes of death (CoD) in the series of critically ill patients with MS verified by autopsy.

METHODS:

We reviewed hospital electronic charts of MS patients treated at the neurological ICU of a tertiary care hospital between 2000 and 2015. We compared clinical and pathological CoD for those who were autopsied.

RESULTS:

Overall, 10 patients were identified (seven female; median age at death 65 years, range 27-80), and six of them were autopsied. The median MS duration prior to ICU admission was 27.5 years (range 1-50), and the median EDSS score at the time of ICU admission was 9 (range 5-9.5). The median length of ICU stay was 3 days (range 2-213). All the individuals in our series had experienced respiratory insufficiency during their ICU stay. The autopsy examination of brain tissue did not reveal evidence of MS lesions in one patient. In another patient, Lewy bodies were found on brain immunohistochemistry.

CONCLUSION:

Mortality in critically ill MS patients is largely driven by respiratory complications. Sporadic disparities between clinical and pathological findings can be expected.