Abstract Details

Title Risk of Worse Short-term Outcomes Associated with hospitalization for migraine and co-morbid psychiatric illness: A Nationwide Population-Based Cohort Study

Topic Headache

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-013

Objective

To evaluate risk factors for worse short-term outcomes with hospitalization for a migraine and comorbid psychiatric illness.

Background Although an association between an episodic migraine and psychiatric comorbidities is well documented, few studies have focused on its effect on short-term outcomes.

Design/Methods We utilized an NRD database to identify hospitalizations (2010-2014) with Migraine (ICD-9CM code 346.xx) as primary and psychiatric 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 an association between baseline characteristics and 30-day readmission were analyzed using multivariable logistic regression model.

Results

We identified 184,215 patients with Migraine, of which 73,134 (39.7%) patients had comorbid psychiatric illness such as mood disorders, anxiety disorders, cognitive disorders, schizophrenia, alcohol, and substance abuse (Mean age 45.7 ± 13.6 years, 83.9 % female). Patients with psychiatric illness had higher comorbidity index ≥3 (15.7 % vs 12.9%, p<0.001), 30 day readmission rate (9.95 % vs 7.06%, p<0.001) (OR:1.35, 95% CI:1.27-1.42, p<0.001), longer mean length of stay (2.9 days vs 2.4 days, p<0.001), and higher mean cost of hospitalization (6,474 $ vs 6,070$, p<0.001). Higher comorbidity index (OR:1.19, 95% CI:1.16-1.22, p<0.001), heart failure (OR:1.30, 95% CI:1.10-1.54, p=0.002), hypertension (OR:1.11, 95% CI:1.05-1.19, p=0.001), hypothyroidism (OR:1.14, 95% CI:1.05-1.23, p=0.001), sleep apnea (OR:1.10, 95% CI:1.001-1.22, p=0.047), weekend admission (OR:1.09, 95% CI:1.02-1.16, p=0.010), and longer length of stay (OR:1.08, 95% CI:1.07-1.09, p<0.001) were predictors of increased readmission. Elective admission (OR:0.84, 95% CI:0.75-0.94, p<0.001), private insurance (OR:0.65, 95% CI:0.61-0.69, p<0.001), Self-payment (OR:0.79, 95% CI:0.72-0.86, p<0.001) and female sex (OR:0.78, 95% CI:0.72-0.83, p<0.001) were predictors of decreased readmission.

Conclusions Comorbid psychiatric condition with migraine is associated with worse 30-days outcome, higher readmission rates, longer length of stay and higher cost of hospitalization. Proactively addressing these illnesses during migraine hospitalization may reduce early readmission, morbidity, and healthcare burden.

Authors/Disclosures
Chirag N. Savani, MD (Tampa General Hospital) PRESENTER	No disclosure on file
	No disclosure on file
James R. Ghattas, DO	No disclosure on file
Luiz De Souza, MD (University of South Florida - JAHVAH)	No disclosure on file
Jose R. Rodriguez, MD (University of South Florida - JAHVAH)	No disclosure on file
Matthew Chung, MD (University of Texas, MD Anderson Cancer Center)	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.
Martin A. Myers, MD (James A Haley VA)	No disclosure on file
Charles W. Brock, MD	No disclosure on file

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