Abstract Details

Title Could Sleep Disorders Cause Increased Readmission Following Hospitalization for Migraine? Analysis from Nationwide Readmission Database 2010-2014

Topic General Neurology

Presentation(s) S32 - General Neurology: Advances in Neurology: From the Clinic to the Bench (3:41 PM-3:52 PM)

Poster/Presentation
Number 002

Objective

To evaluate the effect of sleep disorders on short-term outcome following hospitalization with migraine headaches.

Background Studies show a significant association between migraine and sleep disturbances. In this study, we aimed to evaluate the effect of sleep disorders on short-term outcome following hospitalization with migraine headaches

Design/Methods The Nationwide Readmissions Database (NRD) from 2010-14 was utilized to identify hospitalization with migraine using the ICD-9CM code 346.xx in the primary diagnostic field. This was compared to sleep disorders with appropriate ICD codes in the secondary diagnostic field. Admissions within 30 days of discharge were considered as early readmission and predictors to assess association between baseline characteristics and 30-day were analyzed using a multivariable logistic regression model.

Results We identified 184,215 patients with hospitalization for migraine, of which 11,047(6%) patient had associated sleep disorder(Mean age 45.4±14.5 years, 66.2% female, had a higher comorbidity index (29.1% vs 13.04%,p<0.0001). As compared to patients without sleep disorder, patients with sleep disorder were associated with higher 30 day readmission rate (10.12% vs 8.1%,p<0.0001)(OR:1.29,95% CI:1.16-1.44,p<0.0001), longer mean length of stay (3.3 days vs 2.5days, p<0.0001), and higher mean cost of hospitalization (6933$vs 184$,p<0.0001). Predictors of increased readmission in migraine sufferers with sleep disorders include the following: Higher burden of comorbid condition represented by Charlson comorbidity index(OR:1.19,95% CI:1.08-1.31, p<0.0001), Anxiety disorders (OR:1.25,95% CI:1.01-1.54, p=0.038),Mood disorders (OR:1.59,95% CI:1.33-1.91,p<0.0001), Schizophrenia (OR:1.88,95% CI:1.10-3.20,p=0.021),and weekend hospitalization (OR:1.37,95% CI:1.10-1.69, p=0.004). Predictors of decreased readmission include the following: Private insurance use (OR:0.51, 95% CI:0.41-0.62, p<0.0001), self-payment (OR:0.45,95% CI:0.32-0.65,p<0.0001) and older age (OR:0.98,95% CI:0.97-0.98,p<0.0001

Conclusions Approximately 1 of 10 patients with sleep disorder and migraine were readmitted during our study period. Diagnosis of sleep disorder during migraine hospitalization leads to increased rate of readmission, longer LOS and higher cost of hospitalization. Based on these results, treatment of sleep disorders for migraine sufferers may improve outcomes and reduce healthcare burden

Authors/Disclosures
Jose R. Rodriguez, MD (University of South Florida - JAHVAH) PRESENTER	No disclosure on file
Chirag N. Savani, MD (Tampa General Hospital)	No disclosure on file
	No disclosure on file
Luiz De Souza, MD (University of South Florida - JAHVAH)	No disclosure on file
Tigran Kesayan, MD (VUMC Pain Medicine and Neurology)	Dr. Kesayan has nothing to disclose.
Grace Kim	Mr. Kim has nothing to disclose.
Matthew Chung, MD (University of Texas, MD Anderson Cancer Center)	No disclosure on file
James R. Ghattas, DO	No disclosure on file
Martin A. Myers, MD (James A Haley VA)	No disclosure on file
Charles W. Brock, MD	No disclosure on file

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