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Abstract Details

The Co-occurrence of Dementia in those with Epilepsy is Associated with 30-day Readmission - A Population-based Study
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
122
To determine if dementia in epilepsy patients >40 years old is associated with 30-day hospital readmission, in-hospital mortality, discharge disposition, and length-of-stay.
Dementia and epilepsy often co-occur and are associated with poor health outcomes and increased healthcare utilization. The literature on the association between readmission and co-occurrence of dementia and epilepsy is scant.
This retrospective cohort study used the 2014 Nationwide Readmissions Database, containing data from hospital discharges across the US and readmissions. Epilepsy and dementia were identified using previously validated ICD-9-CM codes. Primary outcome was 30-day readmission. Other outcomes were causes of readmission, discharge disposition, in-hospital mortality and length-of-stay. Multivariable logistic regression was used to examine the association between 30-day readmission and dementia in epilepsy. Other outcomes were compared utilizing unadjusted multinomial logistic, binomial logistic and linear regressions. All analyses accounted for survey weights, cluster and stratum.
Epilepsy patients with dementia (n=15,588) had longer hospital stays [15% (95%CI 10-20%)], and higher odds of readmission [OR 1.11 (95%CI 1.05-1.17)], transfer to another facility [OR 2.18 (95%CI 1.93-2.46)], and in-hospital mortality [OR 1.50 (95%CI 1.25-1.79)] compared to those without dementia (n=86,289). The top two causes of readmission were septicemia (dementia: 14.8%; no dementia: 9.4%) and epilepsy/convulsions (dementia: 5.9%; no dementia: 6.2%). Other top 10 causes of readmissions in those with epilepsy and dementia which were not present in those without dementia included delirium (5.2%), urinary tract infections (5.0%), and aspiration pneumonitis (4.3%).
Dementia in epilepsy is associated with worse outcomes, including higher in-hospital mortality and higher readmissions. Potentially preventable causes of readmission in those with epilepsy and dementia were identified, including delirium, urinary tract infection and aspiration pneumonitis. Future studies are needed to inform interventions aimed at decreasing premature mortality and reducing potentially preventable readmissions in this vulnerable population.
Authors/Disclosures
Helaina Lehrer, MD (South Shore University Hospital Department of Neurosurgery)
PRESENTER 		Dr. Lehrer has nothing to disclose.
No disclosure on file
Churl-Su Kwon, MBBS (Columbia University) Dr. Kwon has nothing to disclose.
Parul Agarwal Parul Agarwal has nothing to disclose.
No disclosure on file
Nathalie Jette, MD, MSc, FRCPC, FÂ鶹´«Ã½Ó³»­ (University of Calgary) Dr. Jette has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE Epilepsia. The institution of Dr. Jette has received research support from NIH. The institution of Dr. Jette has received research support from AES.