Individuals 65 years or older with epilepsy were identified using ICD-9-CM codes in the 2014 Nationwide Readmission Database. 30-day readmission rates and causes of readmissions in older adults with epilepsy were compared to both older adults without and younger adults (18-64 years old) with epilepsy. We identified predictors of readmission in older adults with epilepsy using logistic regression.

There were 92,030 older adults with, 3,166,852 older adults without, and 168,622 younger adults with epilepsy. Proportions of readmissions were higher in older adults with epilepsy (16.17%) than older adults without (12.53%) and younger adults with epilepsy (15.13%). The main cause of readmission for older adults with and without epilepsy was septicemia, and epilepsy/seizure in younger adults with epilepsy. Predictors associated with 30-day readmissions in older adults with epilepsy were: males (OR 1.04, 95%CI 1.00-1.09, p=0.04), non-elective admissions (OR 1.37, 95%CI 1.27-1.48, p<0.01), primary payer (Medicaid vs private insurance OR 1.19, 95%CI 1.02-1.39, p=0.03; Medicare vs private insurance OR  1.11, 95%CI 1.00-1.22, p=0.04), median household income for patient’s zipcode ($66000+ vs $1-$39,999 OR 0.87, 95%CI 0.82-0.92, p<0.01), hospital location in large metropolitan areas (OR 1.22, 95%CI 1.05-1.42, p=0.01), and Charlson-Deyo index (OR 1.11, 95%CI 1.10-1.02, p<0.01).

 Older patients with epilepsy have a higher risk of readmission compared to those without epilepsy. Unlike younger adults with epilepsy who are predominantly re-admitted for seizures, both older populations were mainly admitted for septicemia. Our findings suggest that older adults struggle both with epilepsy and conditions specific to their age group, and this combined risk should be considered by clinicians to prevent readmissions.