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Abstract Details

Short-term Outcomes in Patients with Migraine and Substance Abuse: A 5-year Review Utilizing the Nationwide Readmission Database 2010-14
Headache
S59 - Migraine: Impact, Treatment Patterns and Resource Utilization (1:00 PM-1:11 PM)
001
There is limited data on the short-term outcomes of migraine patients who suffer from substance abuse.  
To compare the 30-day outcome in patients hospitalized with a migraine both with and without substance abuse issues.
We utilized the Nationwide Readmissions Database (NRD) from 2010-14 to identify hospitalization with a migraine using the ICD-9CM code 346.xx in the primary diagnostic field. Patients with substance abuse were identified with HCUP CCS code 661 in the secondary diagnostic field. Admissions within 30 days of discharge were considered as an early readmission.  Predictors to assess the association between baseline characteristics and 30-day readmission were analyzed using multivariable logistic regression model.

We identified 184,215 patients with hospitalization for a primary diagnosis of a migraine during our study period, of which 7,855 (4.3%) patients with a history of substance abuse were identified.  The migraine-substance abuse group consisted more of younger (Mean age 41.5 years vs 45.6 years) Female (72.4%) patients and were associated with higher 30-day readmission rates (13.1% vs 8%; p-value <.0001), a longer mean length of stay (3.2 days vs 2.6 days; p-value <.0001), higher discharge to another facility (2.2% vs 1.4%; p-value <.0001) and higher median cost of hospitalization ($7,011 vs $6,188, p-value <.0001). After adjusting for patient demographics and hospital characteristics, substance abuse was a significant predictor of increased 30-day readmission (OR: 1.52 95% CI:1.36-1.69, p-value <.0001). Incidence of comorbidities such as chronic lung disease (20.2% vs 15.4%), psychiatric disorders such as anxiety (31.1% vs 18.5%), mood disorders (43.2% vs 26.2%) and schizophrenia (2.5% vs 1.1%) were higher in substance abuse group.

Substance abuse in migraine patients is associated with higher 30-day readmission rates, longer length of stay, and a higher cost of hospitalization.  This illustrates part of the typically unseen economic impact of substance abuse in the healthcare system.
Authors/Disclosures
Charles W. Brock, MD
PRESENTER
No disclosure on file
No disclosure on file
Chirag N. Savani, MD (Tampa General Hospital) No disclosure on file
Luiz De Souza, MD (University of South Florida - JAHVAH) No disclosure on file
Matthew Chung, MD (University of Texas, MD Anderson Cancer Center) No disclosure on file
James R. Ghattas, DO No disclosure on file
Jose R. Rodriguez, MD (University of South Florida - JAHVAH) No disclosure on file
Grace Kim Mr. Kim has nothing to disclose.
Tigran Kesayan, MD (VUMC Pain Medicine and Neurology) Dr. Kesayan has nothing to disclose.
Martin A. Myers, MD (James A Haley VA) No disclosure on file