We examined rates and causes of hospital admissions among patients with the following neurological conditions: Brain Tumors (BT), Motor Neuron Disease (MND), Multiple Sclerosis (MS), Parkinson’s disease (PD), Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI), Stroke, Cerebral Palsy (CP).

Understanding hospital admission rates and causes is key to allocating healthcare resources and implementing interventions to avoid preventable hospitalizations. To our knowledge, there are no comprehensive population-based investigations examining rates and causes of admissions among neurological patients.

We used the 2003-2014 National Inpatient Sample database, capturing a representative sample (20%) of US hospitalizations. Hospitalizations for the eight neurological conditions of interest (any diagnostic position) were identified using validated ICD-9-CM case definitions. Admission causes were identified using Clinical Classifications Software for Diagnosis Codes. Descriptive statistics were used to determine weighted rates of admission and top three causes of admissions.

The admission rates in 2003 and 2014 were: BT(0.64%,0.83%), MND(0.03%,0.04%), MS(0.30%,0.42%), PD(0.86%,0.78%), SCI(0.13%,0.18%), TBI(0.80%,0.98%), Stroke(5.14%,5.84%), CP(0.21%,0.30%). For all conditions except PD and CP, the top cause of admission was consistent from 2003 to 2014. The top causes of admission for neurological conditions in 2003 and 2014 were: BT(secondary malignancies,22.6%,18.5%); MND (hereditary and degenerative nervous system conditions,21.9%,18.8%); MS(MS,19.7%,17%); SCI(SCI,25.6%,19.8%); TBI(intracranial injury,57.7%,57.6%); stroke(acute cerebrovascular disease,28.5%,29.1%). For PD, the top cause of admission changed from pneumonia(2003-2008) to septicemia(2009-2014). For CP, the top cause of admission changed from epilepsy/convulsions(2003-2012) to septicemia(2012-2014). Notably, from 2011-2014 septicemia was among the top three causes of all hospital admissions for all controls and neurological patients, except for BT and TBI.

Rates of admission remained largely consistent for all neurological conditions. All conditions except BT have at least one top cause of admission that is potentially preventable. Further emphasis on infection prevention in particular would likely reduce the occurrence of admission in those with neurological conditions.