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Abstract Details

Could Sleep Disorders Cause Increased Readmission Following Hospitalization for Migraine? Analysis from Nationwide Readmission Database 2010-2014
General Neurology
S32 - General Neurology: Advances in Neurology: From the Clinic to the Bench (3:41 PM-3:52 PM)
002
Studies show a significant association between migraine and  sleep disturbances. In this  study, we aimed to evaluate the effect of sleep disorders on short-term outcome following hospitalization with migraine headaches

To evaluate the effect of sleep disorders on short-term outcome following hospitalization with migraine headaches.

The Nationwide Readmissions Database (NRD) from 2010-14 was utilized to identify hospitalization with migraine using the ICD-9CM code 346.xx in the primary diagnostic field.  This was compared to sleep 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 association between baseline characteristics and 30-day were analyzed using a multivariable logistic regression model. 
We identified 184,215 patients with hospitalization for migraine, of which 11,047(6%) patient had associated sleep disorder(Mean age 45.4±14.5 years, 66.2% female, had a higher comorbidity index (29.1% vs 13.04%,p<0.0001).  As compared to patients without sleep disorder, patients with sleep disorder were associated with higher 30 day readmission rate (10.12% vs 8.1%,p<0.0001)(OR:1.29,95% CI:1.16-1.44,p<0.0001), longer mean length of stay (3.3 days vs 2.5days, p<0.0001), and higher mean cost of hospitalization (6933$vs 184$,p<0.0001). Predictors of increased readmission in migraine sufferers with sleep disorders include the following: Higher burden of comorbid condition represented by Charlson comorbidity index(OR:1.19,95% CI:1.08-1.31, p<0.0001), Anxiety  disorders (OR:1.25,95% CI:1.01-1.54, p=0.038),Mood disorders (OR:1.59,95% CI:1.33-1.91,p<0.0001), Schizophrenia (OR:1.88,95% CI:1.10-3.20,p=0.021),and weekend hospitalization (OR:1.37,95% CI:1.10-1.69, p=0.004).  Predictors of decreased readmission include the following: Private insurance use (OR:0.51, 95% CI:0.41-0.62, p<0.0001), self-payment (OR:0.45,95% CI:0.32-0.65,p<0.0001) and older age (OR:0.98,95% CI:0.97-0.98,p<0.0001
Approximately 1 of 10 patients with sleep disorder and migraine were readmitted during our study period. Diagnosis of sleep disorder during migraine hospitalization leads to  increased rate of readmission, longer LOS and higher cost of hospitalization. Based on these results, treatment of sleep disorders for migraine sufferers may improve outcomes and reduce healthcare burden
Authors/Disclosures
Jose R. Rodriguez, MD (University of South Florida - JAHVAH)
PRESENTER
No disclosure on file
Chirag N. Savani, MD (Tampa General Hospital) No disclosure on file
No disclosure on file
Luiz De Souza, MD (University of South Florida - JAHVAH) 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.
Matthew Chung, MD (University of Texas, MD Anderson Cancer Center) No disclosure on file
James R. Ghattas, DO No disclosure on file
Martin A. Myers, MD (James A Haley VA) No disclosure on file
Charles W. Brock, MD No disclosure on file