Abstract Details

Title Predictors of 30-day Readmission Post Index Hospitalization With Epilepsy: 5 Years National Estimate

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P6 - Poster Session 6 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-002

Background Patients with epilepsy represent particularly vulnerable population for readmission mainly due to breakthrough seizures, comorbid psychiatric disease, and complexity of management. This study identifies hospital characteristics and comorbid conditions which can potentially contribute to 30 days readmission.

Objective To identify hospital characteristics and comorbid conditions that potentially contribute to 30 days readmission.

Design/Methods Nationwide Readmissions Database (NRD) from 2010-14 was utilized to identify hospitalization with Epilepsy using ICD-9CM code 345.xx in primary diagnostic field. Admissions within 30 days of discharge were considered as early readmission and predictors to assess association between baseline characteristics and 30-day readmission were analyzed using multivariable logistic regression model.

Results Of 622,467 patients hospitalized for epilepsy, 76,911 (12.4%) were readmitted within 30 days of discharge from index hospitalization (Mean age 55.2 ± 18.3 years, 50.9 % female). Higher comorbidity index (OR:1.10, 95% CI:1.10-1.11, p<0.001), comorbidities like Heart failure (OR:1.19, 95% CI:1.13-1.24, p<0.001), Chronic lung disease (OR:1.17, 95% CI:1.13-1.21, p<0.001), Diabetes (OR:1.10, 95% CI:1.06-1.13, p<0.001), Hypertension (OR:1.07, 95% CI:1.04-1.10, p<0.001), Hypothyroidism (OR:1.06, 95% CI:1.02-1.11, p<0.001), Psychiatric illness (OR:1.22, 95% CI:1.19-1.25, p<0.001), Chronic Kidney disease (OR:1.35, 95% CI:1.30-1.41, p<0.001), chronic liver disease (OR:1.26, 95% CI:1.18-1.34, p<0.001), Cocaine (OR:1.14, 95% CI:1.03-1.26, p<0.001), opioid abuse (OR:1.30, 95% CI:1.18-1.42, p<0.001), discharge to another facility(OR:1.22, 95% CI:1.18-1.25, p<0.001) and longer length of stay during index hospitalization(OR:1.01, 95% CI:1.01-1.02, p<0.001) were predictors of increased 30-day readmission. Elective admission (OR:0.42, 95% CI:0.40-0.45, p<0.001), Private insurance vs Medicare/Medicaid (OR:0.75, 95% CI:0.72-0.78, p<0.001), Self-payment vs Medicare/Medicaid (OR:0.67, 95% CI:0.63-0.71, p<0.001) and teaching hospital admissions (OR:0.96, 95% CI:0.93-0.98, p<0.001) stated otherwise.

Conclusions Approximately 1 of 10 patients hospitalized for epilepsy was readmitted within 30 days. Psychiatric illness, chronic kidney disease, chronic liver disease, discharge to another facility were significant predictors of readmission. Proactively addressing these comorbidities during index hospitalization may decrease urgent health care utilization and reduce health care burden.

Authors/Disclosures
Parisha Bhatia, MD PRESENTER	Dr. Bhatia has nothing to disclose.
	No disclosure on file
Neena Viswanathan, MD (Bluesky)	Dr. Viswanathan has nothing to disclose.
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology)	Dr. Singh has nothing to disclose.
	No disclosure on file