ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1573349
Impact of Surgery in Patients with Multiple Sclerosis: A Nationwide Cohort Study
Provisionally accepted
- 1Department of Physiology and Pharmacology, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden
- 2Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden
- 3Department of Clinical Neuroscience, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden
- 4Department of Neurology, Karolinska University Hospital, Stockholm, Stockholm, Sweden
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Surgery 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.This 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.The 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.We 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 four 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.The 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. tog bort: . tog bort: This study aimed to investigate morbidity associated with surgical interventions in MS patients and controls by assessing comorbidity ratesdisease burden and health care utilization before and after surgery. In addition, we studied mortality rates after surgery in MS patients.
Keywords: Multiple Sclerosis, Surgery, Perioperative Care, health care utilization, postoperative outcome
Received: 08 Feb 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Larsson, Iacobaeus, Oelreich, Eriksson and Kåhlin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jessica Kåhlin, Department of Physiology and Pharmacology, Karolinska Institutet (KI), Stockholm, SE-171 77, Stockholm, Sweden
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