Abstract Details

Title Incidence and Predictors of readmission in patients with Myasthenia Gravis: A National population-based cohort study (2010-14).

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-023

Objective To identify hospital characteristics and co-morbid conditions that are potential contributors to 30-day readmission of patients with Myasthenia gravis (MG).

Background MG is a debilitating neurological disease with scarce literature regarding its epidemiology. As high readmission rates increase US healthcare burden, it is important to understand the risk factors for 30 days readmission so that they can be potentially addressed.

Design/Methods Nationwide Readmissions Database (NRD) from 2010-14 was utilized to identify hospitalization for MG using ICD-9CM code 358.00-358.01 as primary diagnosis. Admissions within 30 days of discharge were considered as early readmission. Multivariable logistic regression model was used for 30-day readmission predictors.

Results We identified 25,672 patients with MG in our study period, of which 4,388 (17.1%) were readmitted within 30 days (mean age 60.9 ± 18.4 years, 52.4 % female). Higher incidence of hypertension (61.2% vs 55%), diabetes (32.2% vs 26%), heart failure (8.4% vs 7%), plasma exchange (25.6% vs 18.5%), mechanical ventilation (6.8% vs 5.6%), higher mean cost of hospitalization (26,915 $ vs 24,020$) and longer length of stay (8.8 vs 7.3 days) was seen in readmitted patients during index hospitalization. Higher comorbidity index (OR:1.08, 95% CI:1.05-1.12, p<0.001), hypertension (OR: 1.16, 95% CI:1.06-1.27, p=0.002), diabetes (OR:1.10, 95% CI:1.01-1.22, p=0.049), plasma exchange (OR:1.51, 95% CI:1.36-1.67, p<0.001), and longer length of stay during index hospitalization (OR:1.011, 95% CI:1.007-1.015, p<0.001) were predictors of increased 30-day readmission. Female gender (OR:0.86, 95% CI:0.79-0.94, p=0.001), IVIG therapy (OR:0.89, 95% CI:0.80-0.99, p=0.037) and elective admission (OR:0.80, 95% CI:0.71-0.90, p<0.001) were predictors of decreased readmission.

Conclusions One out of 8 patients with MG is readmitted within 30 days. We identified that several demographic factors and co-morbidities are associated with increased readmission. We believe that proactive approach and vigilance during hospitalization of MG patients may reduce the readmission rates.

Authors/Disclosures
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology) PRESENTER	Dr. Singh has nothing to disclose.
Chirag N. Savani, MD (Tampa General Hospital)	No disclosure on file
	No disclosure on file
Charles D. Schutt, MD (USF Neurology)	Dr. Schutt has nothing to disclose.
Sheyar Amin, MD (University of South Florida)	Dr. Amin has nothing to disclose.
Yazan M. Suradi, MD	No disclosure on file
Rossitza Chichkova, MD	Dr. Chichkova has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Argenx. Dr. Chichkova has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Grifols. Dr. Chichkova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB.

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