• Alain Lekoubou, Kinfe G Bishu, and Bruce Ovbiagele.
• Department of Neurology, Penn State University, Hershey, Pennyslvania. Electronic address: alekouboulooti@pennstatehealth.psu.edu.
• J Stroke Cerebrovasc Dis. 2020 Feb 1; 29 (2): 104479.

ObjectiveTo examine the association of a comorbid seizure diagnosis with early hospital readmission rates following an index hospitalization for stroke in the United States.MethodsRetrospective analysis of the 2014 National Readmission Database. The study population included adult patients (age >18 years old) with stroke, identified using the International Classification of Disease Ninth Revision, Clinical Modification (ICD-9-CM) codes 433.X1, 434.X1, and 436 for ischemic stroke as well as 430, 431, 432.0, 432.1, and 432.9 for hemorrhagic stroke. A subgroup of patients with a secondary discharge diagnosis of seizures was identified using the ICD-9-CM codes 780.39 and 345.X. We computed all-cause 30-day readmission rates for all strokes and by stroke type (ischemic versus hemorrhagic). Finally, we used a multivariable logistic regression model to examine the independent association between seizure and readmission by stroke type.ResultsOf 271,148 stroke patients, 6.3% (16,970) had a secondary discharge diagnosis of seizures including 5.0% (11,562) of patients with ischemic stroke and 13.4% (5,409) with hemorrhagic stroke. Overall readmission rate for stroke patients was 11.9% (hemorrhagic stroke: 14.2% versus ischemic strokes: 11.6%). Thirty-day readmission rate was higher in patients with seizures for all strokes (15.6% versus 11.7%, P value <.001), ischemic strokes (15.0% versus11.4%, P value <.001), and hemorrhagic strokes (16.7% versus 13.8%, P value <.001). After adjusting for several patient-specific and healthcare system-specific confounders, hospitalized stroke patients with comorbid seizure diagnosis were more likely than those without seizures to be readmitted within 30 days (OR: 1.20, 95% CI: 1.14-1.25).ConclusionThe presence of a comorbid diagnosis of seizure disorder in a hospitalized stroke patient significantly raises the occurrence of early hospital readmission in the United States.Copyright © 2019 Elsevier Inc. All rights reserved.

38 keywords...

hide…