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Fibromyalgia and Myositis Linked to Higher Burden and Disability in Patients with Migraine

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Abstract

The increase in migraine frequency—with shift towards chronicity—promotes an enhancement of the central hypersensitivity which has been linked with fibromyalgia and myositis (FM). Migraine patients with FM have been known to have higher burden of headaches across studies, but this is the first population-based study to evaluate disability and morbidity in migraine patients with concurrent FM. We performed a retrospective cross-sectional analysis of migraine hospitalizations using the nationwide database to determine cost, hospital stay, disability, and discharge disposition. This analysis was performed in migraine patients with and without FM using ICD-9-CM codes. We performed weighted analyses using chi-square and t test. Among year 2014 hospitalizations, we identified FM patients and regression analysis was performed to evaluate whether migraine or other headache disorders were predictors of FM hospitalization. Between years 2003 and 2014, of the total 446,446 migraine hospitalizations, 22,735(5.09%) patients had concurrent FM. Migraine patients with FM had higher prevalence of loss of function (8.4% vs. 6.5%, p<0.0001) and transfer to rehabilitation facilities (5.5% vs. 4.5%, p<0.0001) compared to those without FM. Migraine patients with FM also had higher hospitalization stay and cost. Through regression analysis, we found that migraine (aOR, 3.03; p<0.0001), cluster headache (aOR, 1.71; p=0.0124), and tension headache (aOR, 1.87; p<0.0001) were highly associated with FM hospitalization. FM was associated with significant increase in disability, morbidity, hospitalization stay, and cost in patients admitted with migraine. On the basis of this study finding, it would be reasonable to screen migraine patients with depression, anxiety, or other psychiatric disorders for symptoms of FM to mitigate the burden.

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Author notes

  1. Tapan Kavi and Ashish Kapoor contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology & Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA

    Urvish K. Patel

  2. Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Preeti Malik, Bakhtiar M. Rasul & Saleha Saiyed

  3. Department of Internal Medicine, Albert Einstein College of Medicine, New York, NY, USA

    Richa Sheth

  4. Department of Internal Medicine, CarePoint Health, Bayonne Medical Center, Bayonne, NJ, USA

    Princy Malhi & Amita Kapoor

  5. Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ, USA

    Tapan Kavi

  6. Department of Neurology, Jersey City Medical Center-RWJ Barnabas Health & Bayonne, Medical Center-CarePoint Health, Bayonne, NJ, USA

    Ashish Kapoor

Authors
  1. Urvish K. Patel
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Contributions

U.P. and P.M. conceive of the idea and performed biostatistics and analysis. R.S. and P.M. wrote the manuscript with support from A.K., B.R., and S.S. who contributed to the literature review, tables, figure, and citation. A.K. and T.K. supervised the project.

Corresponding author

Correspondence to Urvish K. Patel.

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The authors declare that there is no conflict of interest.

Informed Consent

The data has been taken from Nationwide Inpatient Sample, which is a deidentified database from “Health Care Utilization Project (HCUP)” sponsored by the Agency for Healthcare Research and Quality, so informed consent or IRB approval was not needed for the study. The relevant ethical oversight and HCUP Data Use Agreement (HCUP-4Q28K90CU) were obtained for the study.

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Patel, U.K., Malik, P., Sheth, R. et al. Fibromyalgia and Myositis Linked to Higher Burden and Disability in Patients with Migraine. SN Compr. Clin. Med. 1, 882–890 (2019). https://doi.org/10.1007/s42399-019-00129-7

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