Abstract Details

Title Predictors of 30-day readmission after index hospitalization for epilepsy: a 5-year national estimate using the Nationwide Readmission (NRD) database

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-029

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

Background Patients with epilepsy represent a particularly vulnerable population for readmission mainly due to breakthrough seizures, comorbid psychiatric disease, and complexity of medication regimens.

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

Results We identified 622,467 patients with hospitalization for epilepsy, of which 76,911 (12.4%) patients 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 such as 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) were predictors of decreased readmission.

Conclusions Approximately 1 out of 10 patients hospitalized for epilepsy was readmitted within 30 days. Comorbidities such as psychiatric illness, chronic kidney disease, chronic liver disease, discharge to another facility were major significant predictors of readmission. Proactively addressing these comorbidities during index hospitalization may decrease urgent healthcare utilization and reduce the burden.

Authors/Disclosures
Chirag N. Savani, MD (Tampa General Hospital) PRESENTER	No disclosure on file
	No disclosure on file
Colby A. Richardson, MD (TeleSpecialists, LLC)	Dr. Richardson has nothing to disclose.
Sheyar Amin, MD (University of South Florida)	Dr. Amin has nothing to disclose.
Stephanie E. MacIver, MD (University of South Florida Department of Neurology)	No disclosure on file
	No disclosure on file
Selim R. Benbadis, MD, FAAN (University of South Florida)	Dr. Benbadis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stratus. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for SK Lifesciences. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Jazz. Dr. Benbadis has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Catalyst. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Neurelis. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Livanova. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for UCB.

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