Identification of 30-day readmission risk factors in seizure patients at a large South Jersey regional hospital.

Due to increased health care costs, Centers for Medicare and Medicaid Services (CMS) may penalize hospitals for having too many readmissions within 30 days of discharge. With the 30-day readmission rate of epilepsy patients nearing 10%, identifying factors that may lead to a reduction in readmission would be of great benefit to patients and hospital systems.

A retrospective study of of patients age 18 or above who were discharged from the hospital with a diagnosis of epilepsy and/or seizure from 2016 to 2018.  Patients who were pregnant, discharged to hospice or discharged from ED or CDU were not included. The population was divided into 2 groups, patients readmitted within 30 days or not. Variables evaluated include demographics, social factors, medical and psychiatric history, level of care, length of stay and epilepsy specific therapies and diagnostic studies.

Of 496 patients evaluated in this study, 40 had 30-day re-admissions. Factors that were statistically significant included mean age (p<0.021), history of stroke (p<0.023), the primary service (i.e. ICU, Hospitalist, Neurology, or Other) admitted under (p<0.003), whether EEG was performed on initial admission (p<0.020), routine EEG results (p<0.011), and MRI results (p<0.044)

The results of this study help identify factors that contribute to early re-admission in epilepsy patients. The results suggest that the greatest risk of re-admission include those with an older mean age, comorbid strokes, admission to non-neurology services, without an EEG recording on initial admission, with abnormal routine EEG results, and with abnormal MRI brain interpretations. Special consideration should be made towards these factors to help mitigate 30-day readmission rates.