Abstract Details

Title How Often And What Predicts…30-Day Hospital Readmissions After Generalized Convulsive Status Epilepticus?

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S36 - Epilepsy/Clinical Neurophysiology (EEG) II (1:55 PM-2:06 PM)

Poster/Presentation
Number 006

Background Status epilepticus is one of the major neurologic emergencies. It often carries significant disability that increases the clinical and financial burden on patients, their families and the health care system.

Objective To assess trends and identify independent predictors of 30-day hospital readmission among patients with a discharge diagnosis of generalized convulsive status epilepticus (GCSE).

Design/Methods The 2014 Nationwide Readmission Database was used as data source. We included adults (Age ≥18 years) with a primary discharge diagnosis of GCSE, identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 345.3. We excluded patients who died during hospitalization and those who had missing information on the length of stay or were discharged in December 2014. Overall 30-readmission rate was computed and pre-specified groups were compared by their 30-day readmission status. We applied a multiple logistic regression analysis to identified independent predictors of 30-day readmission adjusting for potential confounders.

Results Among 14,562 (weighted 587,677) adults discharged with a diagnosis of GCSE, 2520 (17.3%) were readmitted within 30 days. On multivariate logistic analysis, patients discharged against medical advice (Odds ratio-OR 1.45; 95% Confidence Interval-CI, 1.09-1.92), those discharged to short term hospital (OR 1.39; 95% CI 1.0-1.88), those with comorbid conditions (OR for Charleson comorbidities index = 1 and ≥ 2 was 1.12, 95%CI 1.0-1.36 and 1.32, 95% CI 1.17-1.48 respectively) and length of stay exceeding 6 days (OR 1.42; 95% CI 1.05-192) had a greater odd of 30 day readmission, while an inverse association was noted for patients aged 45+ years and those in high income households.

Conclusions Approximately, one in five patients with GCSE was readmitted within 30 days after discharge. Greater attention to high risk subgroups may identify opportunities to ameliorate the clinical and economic burden of early readmissions after GCSE.

Authors/Disclosures
Mohamad Rahwan, MD (TriHealth) PRESENTER	No disclosure on file
Alain Z. Lekoubou Looti, MD (Penn StateHealth, Hershey Medical Center)	Dr. Lekoubou Looti has nothing to disclose.
	No disclosure on file
Bruce I. Ovbiagele, MD, MSc, FAAN (San Francisco VA)	Dr. Ovbiagele has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Stroke Association. Dr. Ovbiagele has received research support from National Institutes of Health. Dr. Ovbiagele has a non-compensated relationship as a President with Society for Equity Neuroscience that is relevant to AAN interests or activities. Dr. Ovbiagele has a non-compensated relationship as a Board Member with World Stroke Organization that is relevant to AAN interests or activities.

��ɫ��

��ɫ��