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Abstract Details

National estimate of incidence and predictors of 30-day readmission associated with multiple sclerosis using nationwide readmission database
Multiple Sclerosis
P4 - Poster Session 4 (5:30 PM-6:30 PM)
15-071
To evaluate incidence and predictors of 30 days readmission with Multiple sclerosis.
There are approximately 400,000 patients in the US with a diagnosis of multiple sclerosis (MS). We utilized the Nationwide Readmissions Database (NRD) to assess the incidence and predictors of 30-day readmission associated with MS.
A retrospective study utilizing NRD was conducted to identify hospitalizations (2010-2014) with MS (ICD-9CM code 340) as a primary diagnosis. 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.

We identified 84,836 patients with primary diagnosis of MS (mean age 48±14 years, 72.6% female), of which 8,373 (9.9%) were readmitted within 30 days. Readmitted patients were associated with higher mean cost of hospitalization ($11,589 vs $10,029, p<0.001), longer length of stay (LOS) (6.6 vs 5.4 days, p<0.001), and higher incidence of comorbidities such as hypertension (39.4% vs 31.1%), diabetes mellitus (17.7% vs 12.9%), epilepsy (7.2% vs 4.7%) and heart failure (2.9% vs 1.2%). Multivariate analysis for predictors of 30-day readmission showed age 50-59 (OR:1.22, 95%CI:1.11-1.34, p<0.001) and 60-69 (OR:1.27, 95% CI:1.14-1.42, p<0.001), higher comorbidity index (OR:1.13, 95%CI:1.10-1.16, p<0.001), diabetes mellitus (OR:1.24, 95%CI:1.04-1.46, p<0.001), hypertension (OR:1.20, 95%CI:1.13-1.27, p<0.001), heart failure (OR:1.36, 95%CI:1.14-1.62, p=0.001), epilepsy (OR:1.35, 95%CI:1.22-1.50, p<0.001), plasma exchange (OR:1.61, 95%CI:1.32-1.95, p<0.001), intubation (OR:1.46, 95%CI:1.11-1.91, p=0.006), weekend hospitalization (OR:1.16, 95%CI:1.09-1.23, p<0.001) and prolonged LOS (OR:1.007, 95%CI:1.004-1.010, p<0.001) were predictors of increased readmission. Private insurance (OR:0.69, 95%CI:0.65-0.73, p<0.001) and elective admission (OR:0.72, 95%CI:0.65-0.79, p<0.001) were predictors of decreased readmission.
one out of 10 patients with MS gets readmitted within 30 days post discharge, with comorbidities such as diabetes, heart failure, epilepsy, and exposure to plasma exchange being significant predictors of readmission. Therefore, proactively addressing these comorbidities during hospitalizations may help in reducing readmissions.
Authors/Disclosures

PRESENTER 		No disclosure on file
Natalie Moreo, MD Dr. Moreo has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for PRIME 好色先生, LLC. Dr. Moreo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Moreo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Apollo Medical Communications. The institution of Dr. Moreo has received research support from InnoCare. The institution of Dr. Moreo has received research support from Novartis .
Chirag N. Savani, MD (Tampa General Hospital) No disclosure on file
Chetan P. Gandhy, MD (Eli Lilly) No disclosure on file
Derrick Robertson, MD Dr. Robertson has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Greenwich Biosciences. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Horizon. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Janssen. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi Genzyme. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Robertson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mallinckrodt. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Robertson has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Biogen. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Robertson has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Genentech. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi Genzyme. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for PRIME CME. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Janssen. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Horizon. Dr. Robertson has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for TG Therapeutics. Dr. Robertson has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for McVeigh. Dr. Robertson has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Mccumber. Dr. Robertson has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Goodis. The institution of Dr. Robertson has received research support from Biogen. The institution of Dr. Robertson has received research support from EMD Serono. The institution of Dr. Robertson has received research support from Jansenn. The institution of Dr. Robertson has received research support from Genentech. The institution of Dr. Robertson has received research support from Patient-Centered Outcomes Research Institute. The institution of Dr. Robertson has received research support from Novartis. The institution of Dr. Robertson has received research support from Sanofi Genzyme. The institution of Dr. Robertson has received research support from TG Therapeutics. The institution of Dr. Robertson has received research support from Prime. The institution of Dr. Robertson has received research support from Greenwich Biosciences. The institution of Dr. Robertson has received research support from Atara Biotherapeutics. The institution of Dr. Robertson has received research support from CorEvitas. The institution of Dr. Robertson has received research support from Anokion. The institution of Dr. Robertson has received research support from UCB Biosciences. Dr. Robertson has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Consortium of Multiple Sclerosis Centers. Dr. Robertson has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Multiple Sclerosis Association of America.