Seizure comorbidity boosts odds of 30-day readmission after an index hospitalization for sepsis

Jonah Fox, Alain Zingraff Lekoubou Looti, Kinfe G. Bishu, Bruce Ovbiagele

Research output: Contribution to journalArticle

Abstract

Objective: The objective of this study was to evaluate the association between comorbid seizures and hospital readmissions within 30 days following an index hospitalization for sepsis. Methods: We analyzed data from 445,489 adult discharges derived from the 2014 National Readmission Database, to evaluate the association of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis of seizure during an index hospitalization for sepsis and 30-day readmission rates. We excluded patients who died during hospitalization and those who had missing information on the length of stay or were discharged in December 2014. Prespecified groups were compared by their 30-day readmission and seizure status. We applied a multivariable logistic regression analysis to assess the independent association between seizure and readmission. Results: Nearly one out of 15 patients discharged with a primary diagnosis of sepsis had comorbid seizures, of which 97% were status epilepticus. Patients with sepsis and comorbid seizures were 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures. Additional factors associated with a significantly higher risk for hospital readmission included male sex, age 45–84 years, increased length of stay and cost of primary admission, greater medical comorbidities, and discharge destination. Patients with seizures during their index hospitalization were significantly more likely to have also had a concurrent stroke or the central nervous system (CNS) infection compared with patients without seizures. Conclusions: Seizures are not uncommon, and patients with sepsis and comorbid seizures are 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalEpilepsy and Behavior
Volume95
DOIs
StatePublished - Jun 1 2019

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Comorbidity
Sepsis
Seizures
Hospitalization
Patient Readmission
International Classification of Diseases
Length of Stay
Central Nervous System Infections
Status Epilepticus
Logistic Models
Stroke
Regression Analysis
Databases
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

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title = "Seizure comorbidity boosts odds of 30-day readmission after an index hospitalization for sepsis",
abstract = "Objective: The objective of this study was to evaluate the association between comorbid seizures and hospital readmissions within 30 days following an index hospitalization for sepsis. Methods: We analyzed data from 445,489 adult discharges derived from the 2014 National Readmission Database, to evaluate the association of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis of seizure during an index hospitalization for sepsis and 30-day readmission rates. We excluded patients who died during hospitalization and those who had missing information on the length of stay or were discharged in December 2014. Prespecified groups were compared by their 30-day readmission and seizure status. We applied a multivariable logistic regression analysis to assess the independent association between seizure and readmission. Results: Nearly one out of 15 patients discharged with a primary diagnosis of sepsis had comorbid seizures, of which 97{\%} were status epilepticus. Patients with sepsis and comorbid seizures were 30{\%} more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures. Additional factors associated with a significantly higher risk for hospital readmission included male sex, age 45–84 years, increased length of stay and cost of primary admission, greater medical comorbidities, and discharge destination. Patients with seizures during their index hospitalization were significantly more likely to have also had a concurrent stroke or the central nervous system (CNS) infection compared with patients without seizures. Conclusions: Seizures are not uncommon, and patients with sepsis and comorbid seizures are 30{\%} more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures.",
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Seizure comorbidity boosts odds of 30-day readmission after an index hospitalization for sepsis. / Fox, Jonah; Lekoubou Looti, Alain Zingraff; Bishu, Kinfe G.; Ovbiagele, Bruce.

In: Epilepsy and Behavior, Vol. 95, 01.06.2019, p. 148-153.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Seizure comorbidity boosts odds of 30-day readmission after an index hospitalization for sepsis

AU - Fox, Jonah

AU - Lekoubou Looti, Alain Zingraff

AU - Bishu, Kinfe G.

AU - Ovbiagele, Bruce

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N2 - Objective: The objective of this study was to evaluate the association between comorbid seizures and hospital readmissions within 30 days following an index hospitalization for sepsis. Methods: We analyzed data from 445,489 adult discharges derived from the 2014 National Readmission Database, to evaluate the association of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis of seizure during an index hospitalization for sepsis and 30-day readmission rates. We excluded patients who died during hospitalization and those who had missing information on the length of stay or were discharged in December 2014. Prespecified groups were compared by their 30-day readmission and seizure status. We applied a multivariable logistic regression analysis to assess the independent association between seizure and readmission. Results: Nearly one out of 15 patients discharged with a primary diagnosis of sepsis had comorbid seizures, of which 97% were status epilepticus. Patients with sepsis and comorbid seizures were 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures. Additional factors associated with a significantly higher risk for hospital readmission included male sex, age 45–84 years, increased length of stay and cost of primary admission, greater medical comorbidities, and discharge destination. Patients with seizures during their index hospitalization were significantly more likely to have also had a concurrent stroke or the central nervous system (CNS) infection compared with patients without seizures. Conclusions: Seizures are not uncommon, and patients with sepsis and comorbid seizures are 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures.

AB - Objective: The objective of this study was to evaluate the association between comorbid seizures and hospital readmissions within 30 days following an index hospitalization for sepsis. Methods: We analyzed data from 445,489 adult discharges derived from the 2014 National Readmission Database, to evaluate the association of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis of seizure during an index hospitalization for sepsis and 30-day readmission rates. We excluded patients who died during hospitalization and those who had missing information on the length of stay or were discharged in December 2014. Prespecified groups were compared by their 30-day readmission and seizure status. We applied a multivariable logistic regression analysis to assess the independent association between seizure and readmission. Results: Nearly one out of 15 patients discharged with a primary diagnosis of sepsis had comorbid seizures, of which 97% were status epilepticus. Patients with sepsis and comorbid seizures were 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures. Additional factors associated with a significantly higher risk for hospital readmission included male sex, age 45–84 years, increased length of stay and cost of primary admission, greater medical comorbidities, and discharge destination. Patients with seizures during their index hospitalization were significantly more likely to have also had a concurrent stroke or the central nervous system (CNS) infection compared with patients without seizures. Conclusions: Seizures are not uncommon, and patients with sepsis and comorbid seizures are 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures.

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