Assistant Professor Icahn School of Medicine at Mount Sinai New York, New York
Rationale: There is no nationally representative U.S. data on 30-day readmission rate after Epilepsy Monitoring Unit (EMU) discharge to guide policy and quality discussions. We, therefore, aimed to determine 30-day readmission rate after EMU discharge in a nationally representative sample, as well as patient, clinical, and hospital characteristics associated with readmission. Methods: This is a retrospective cohort study of adults discharged from an elective hospitalization with continuous EEG monitoring (ICD-9-CM procedure code: 891.9), sampled from the Healthcare Cost and Utilization Project’s 2014 Nationwide Readmissions Database. The primary outcome of interest was 30-day non-elective readmission. Descriptive statistics and multivariable logistic regression models were built to characterize 30-day non-elective readmission after accounting for survey weights, cluster and stratum. Regression models were adjusted for age, sex, payer, median household income, discharge disposition, admission day, Elixhauser comorbidity index, length-of-stay (LOS), bedsize of hospital and type of hospital (private non-profit, private, or public). Results: Overall, 6,577 admissions met inclusion criteria, of which 232 people (3.37%) were non-electively readmitted within 30 days (60 people or 0.815 were electively readmitted within 30 days). Variables associated with readmission included: increasing age (1 year increase AOR = 1.01; 95% CI 1.00-1.02), male sex (AOR = 1.52; 95% CI 1.21-1.91), longer LOS (1 day increase AOR = 1.04; 95% CI 1.01-1.07), weekend admission (AOR 2.16 (1.10-4.25) and higher Elixhauser comorbidity index score (1 point increase AOR = 1.03; 95% CI 1.02, 1.04). The most common primary reasons for readmission were: epilepsy/ convulsion (27.1%), septicemia except in labor (6.8%), surgical procedures or medical care complications (5.9%), mood disorders (5.4%) and device/implant/graft complication (2.6%). Conclusions: Patients electively admitted for continuous EEG monitoring are infrequently readmitted. National readmissions rates are significantly lower than those reported in prior center-specific studies. The most common reason for readmission in our study was seizure or epilepsy which suggests that a portion of non-elective readmission after discharge from an EMU may be avoidable. Funding: Please list any funding that was received in support of this abstract.: This work was supported by the Department of Neurology at the Icahn School of Medicine.
