Association of seizure co-morbidity with early hospital readmission among traumatic brain injury patients

ABSTRACT

Objective

To assess the frequency of seizure co-morbidity and its independent association with 30-day readmission rate among patients hospitalized with traumatic brain injury (TBI) in the United States.

Methods

The data source was the 2014 Nationwide Readmission Database. We included adults (Age ≥18 years) with a primary discharge diagnosis of TBI, identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 800.0, 801.9, 803.0, 804.9, 850.0–854.1, and 959.01. Seizures were diagnosed using the ICD-9-CM codes of 345.x and 780.39. Overall and across pre-specified groups 30-readmission rate was computed. Logistic regression analysis was used to identify independent predictors of 30-day readmission.

Results

Among 76,062 unweighted adults discharged with a diagnosis of TBI, 7,776 (10.14%) had a secondary discharge diagnosis of seizures.A total of 1,751 (2.3%) patients with a primary discharge diagnosis of TBI were readmitted within 30 days. On multivariate logistic analysis, patients discharged with a secondary diagnosis of seizures were 18% more likely to be readmitted within 30 days compared to those without seizures (OR 1.18, 95% CI: 1.01–1.39, P = .42).

Conclusion

One in 10 patients hospitalized with TBI in the US have a co-morbid seizure disorder. Seizure co-morbidity conferred 18% greater odds of being readmitted within 30 days.

KEYWORDS:

• Traumatic brain injury
• seizures
• readmission
• United States

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.