Readmissions for Cardiac and Non-cardiac Causes Among those with Epilepsy or Multiple Sclerosis
Abstract number :
837
Submission category :
17. Public Health
Year :
2020
Submission ID :
2423171
Source :
www.aesnet.org
Presentation date :
12/7/2020 9:07:12 AM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
H. Nicolas Lemus, Icahn School of Medicine at Mount Sinai Downtown; Parul Agarwal - Icahn School of Medicine at Mount Sinai; Churl-Su Kwon - Icahn School of Medicine at Mount Sinai; Anusha Yeshokumar - Icahn School of Medicine at Mount Sinai; Mandip Dhamo
Rationale:
Studies suggest that certain antiseizure medications are associated with an increase in serological cardiovascular disease (CVD) markers which could increase mortality. The purpose of this study was to determine proportions of cardiac readmissions in epilepsy compared to multiple sclerosis (MS) or population with neither condition.
Method:
We used the 2014 National Readmissions Database and validated ICD-9-CM codes to identify patients with epilepsy (N=202,938) and MS (N=29,559) aged 18 years and older. Primary outcomes of interest were: 1) 30-day readmissions due to cardiac causes; 2) 30-day readmissions due to other causes, and 3) no 30-day readmissions. Predictors of 30-day readmissions for cardiac causes in epilepsy were examined using multinomial logistic regression after adjusting for sex, household income, primary payer, discharge disposition, admission type and comorbidity (Charlson index).
Results:
The proportion of 30-day readmissions for epilepsy vs. MS were: 1) due to cardiac causes (0.17% vs. 0.13%); 2) due to other causes (0.27% vs. 0.20%). The odds of 30-day cardiac readmissions in epilepsy and MS were lower compared to those without either conditions (OR=0.64, 95%CI 0.57-0.73, p< 0.0001; OR=0.60, 95%CI 0.43-0.84, p=0.003). The odds of non-cardiac readmissions were higher in both epilepsy and MS (OR=1.45, 95%CI 1.42-1.47, p< 0.0001; OR=1.3, 95%CI 1.24-1.37, p< 0.0001). Among those with epilepsy, increasing age and Charlson index ≥3 were associated with higher odds of 30-day cardiac readmissions. A higher proportion of those with epilepsy readmitted within 30 days due to cardiac causes died in hospital (10.09%) than those with MS (6.42%) or those without either condition (5.61%).
Conclusion:
Hospital readmissions for cardiac disease are lower while those for other causes are higher in people with epilepsy or MS. However, epilepsy patients readmitted for cardiac causes had higher odds of dying in hospital. These findings need to be further explored to help in the identification of treatments that could reduce mortality in epilepsy.
Funding:
:None
Public Health