TY - JOUR
T1 - Early-hospital readmission after generalized status epilepticus during stroke hospitalization
AU - Lekoubou, Alain
AU - Bishu, Kinfe G.
AU - Ovbiagele, Bruce
N1 - Funding Information:
We used the 2014 Nationwide Readmission Database (NRD) as the data source for this study. The NRD is part of the Healthcare Cost and Utilization Project (HCUP), which is sponsored by the Agency for Healthcare Research and Quality (AHRQ). It contains nationwide information on hospital readmissions for all types of payers and the uninsured. The NRD is a sample of convenience derived from the State Inpatient Databases (SID), and not a sample of hospitals or discharges used to generate national estimates of readmissions [ 7 ]. In 2014, the NRD included 27 SID which were geographically dispersed and accounted for 58% of the total US resident population and 57% of all US hospitalizations. The NRD contains unweighted 17.2 million discharges (weighted 36 million discharges) in the United States. It includes three discharge-level files (core file, severity file, diagnosis, and procedure group file) and hospital-level files. The core file contains data information such as demographic characteristics, admission week, length of stay (LOS), mortality, payer information, elective vs non-elective admission days from ‘start date’ to admission, ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis and procedures, discharge weights, and total hospital charges. The severity file contains comorbidity measure for ICD-9-CM codes, risk of mortality, and severity of illness subclass. The diagnosis and procedures file contains chronic condition indicators, Clinical Classification Software (CCS) for ICD-9-CM diagnosis and procedures. The hospital file contains hospital teaching status, bed size, control/ownership of hospitals, and total hospital discharges [ 8 ]. This study was waived by the Institutional Review Board (IRB) as the database contains de-identified patient information for confidentiality purposes. Details about the NRD are available online at https://www.hcup-us.ahrq.gov/db/nation/nrd/nrddbdocumentation.jsp
Funding Information:
We used the 2014 Nationwide Readmission Database (NRD) as the data source for this study. The NRD is part of the Healthcare Cost and Utilization Project (HCUP), which is sponsored by the Agency for Healthcare Research and Quality (AHRQ). It contains nationwide information on hospital readmissions for all types of payers and the uninsured. The NRD is a sample of convenience derived from the State Inpatient Databases (SID), and not a sample of hospitals or discharges used to generate national estimates of readmissions [7]. In 2014, the NRD included 27 SID which were geographically dispersed and accounted for 58% of the total US resident population and 57% of all US hospitalizations. The NRD contains unweighted 17.2 million discharges (weighted 36 million discharges) in the United States. It includes three discharge-level files (core file, severity file, diagnosis, and procedure group file) and hospital-level files. The core file contains data information such as demographic characteristics, admission week, length of stay (LOS), mortality, payer information, elective vs non-elective admission days from ?start date? to admission, ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis and procedures, discharge weights, and total hospital charges. The severity file contains comorbidity measure for ICD-9-CM codes, risk of mortality, and severity of illness subclass. The diagnosis and procedures file contains chronic condition indicators, Clinical Classification Software (CCS) for ICD-9-CM diagnosis and procedures. The hospital file contains hospital teaching status, bed size, control/ownership of hospitals, and total hospital discharges [8]. This study was waived by the Institutional Review Board (IRB) as the database contains de-identified patient information for confidentiality purposes. Details about the NRD are available online at https://www.hcup-us.ahrq.gov/db/nation/nrd/nrddbdocumentation.jsp
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/1/15
Y1 - 2021/1/15
N2 - Objective: To assess the relationship between generalized convulsive status epilepticus (GCSE) during an index stroke hospitalization and occurrence of 30-day hospital readmission. Methods: Retrospective analysis of data within the 2014 National Readmission Database, a national dataset tracking readmissions in the United States. We identified patients with an index discharge diagnosis of stroke using the International Classification of Disease, Ninth Revision, Clinical Modification (433.X1, 434.X1, and 436 for ischemic stroke and 430, 431, 432.0, 432.1, and 432.9 for hemorrhagic stroke) and a subset of patients with GCSE (345.3). We explored the association between GCSE and 30-day readmission using multivariable logistic regression, while applying recommended survey weights. Results: Of 271,148 adults with a primary diagnosis of stroke hospitalizations in the US in 2014, 591 (0.21%) had GCSE. The prevalence of GCSE was 0.14% among ischemic stroke patients and 0.64% among hemorrhagic stroke patients. Readmission rates were 11.9% for all strokes, 11.6% for ischemic strokes, and 14.2% for hemorrhagic strokes. Readmission rates were significantly higher for those with GCSE vs. without GCSE regardless of stroke type. Adjusted odds ratios for the association of GCSE with 30-day readmission were 1.30 (95% CI: 1.02–1.65) for all strokes, 1.19 (95% CI: 0.84–1.71) for ischemic strokes, and 1.39 (95% CI: 0.92–2.10 0.09) for hemorrhagic stroke. Conclusion: Approximately one in eight hospitalized stroke patients who experience in-hospital GCSE are re-admitted to a hospital within 30 days with a nominally higher rate of readmissions among those with hemorrhagic stroke.
AB - Objective: To assess the relationship between generalized convulsive status epilepticus (GCSE) during an index stroke hospitalization and occurrence of 30-day hospital readmission. Methods: Retrospective analysis of data within the 2014 National Readmission Database, a national dataset tracking readmissions in the United States. We identified patients with an index discharge diagnosis of stroke using the International Classification of Disease, Ninth Revision, Clinical Modification (433.X1, 434.X1, and 436 for ischemic stroke and 430, 431, 432.0, 432.1, and 432.9 for hemorrhagic stroke) and a subset of patients with GCSE (345.3). We explored the association between GCSE and 30-day readmission using multivariable logistic regression, while applying recommended survey weights. Results: Of 271,148 adults with a primary diagnosis of stroke hospitalizations in the US in 2014, 591 (0.21%) had GCSE. The prevalence of GCSE was 0.14% among ischemic stroke patients and 0.64% among hemorrhagic stroke patients. Readmission rates were 11.9% for all strokes, 11.6% for ischemic strokes, and 14.2% for hemorrhagic strokes. Readmission rates were significantly higher for those with GCSE vs. without GCSE regardless of stroke type. Adjusted odds ratios for the association of GCSE with 30-day readmission were 1.30 (95% CI: 1.02–1.65) for all strokes, 1.19 (95% CI: 0.84–1.71) for ischemic strokes, and 1.39 (95% CI: 0.92–2.10 0.09) for hemorrhagic stroke. Conclusion: Approximately one in eight hospitalized stroke patients who experience in-hospital GCSE are re-admitted to a hospital within 30 days with a nominally higher rate of readmissions among those with hemorrhagic stroke.
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U2 - 10.1016/j.jns.2020.117258
DO - 10.1016/j.jns.2020.117258
M3 - Article
C2 - 33278662
AN - SCOPUS:85097133510
SN - 0022-510X
VL - 420
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
M1 - 117258
ER -