Emergency Department Visits and Readmissions in Patients with Psychogenic Non-Epileptic Seizures at a Safety Net Hospital
Abstract number :
3.226
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2021
Submission ID :
1825678
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:44 AM
Authors :
rohit das, MD - UT Southwestern; Mark Agostini, MD - neurology - UTSW; Sasha Alick Lindstrom, MD - UTSW; Sasha Alick Lindstrom, MD - UTSW; Steven Brown, MPH - Parkland Hospital; Hina Dave, MD - UTSW; Marisara Dieppa, MD - UTSW; Kan Ding, MD - UTSW; Alexander Doyle, MD - UTSW; Jay Harvey, MD - UTSW; Ryan Hays, MD - UTSW; Ghazala Perven, MD - UTSW; Irina Podkorytova, MD - UTSW; Swetha Ramamurthy, MD - UTSW; Rodrigo Zepeda, MD - UTSW
Rationale: Readmissions and emergency department visits after an index admission have become a quality measure due to associations with poor outcomes and increased healthcare costs. Readmissions and ED encounters have been studied in a variety of conditions including epilepsy but have not been examined exclusively in PNES. In this study we examined the rate of readmissions and ED visits after a discharge from an EMU in a safety net hospital. We also determined patient phenotypes that are associated with readmissions.
Methods: Retrospective chart review study with index admission being a discharge from an EMU between January 1 and December 31, 2016 with follow-up till August 31 2020. We obtained data regarding demographic, medical and psychiatric history, social history and treatment interventions. Our outcome variables were hospital readmissions and ED visits 30 days following the index discharge and readmissions and ED visits 30 days thereafter.
Results: Seven patients (5.7%) had an ED visit or hospital readmission within 30 days of discharge. Twenty-eight (22.9%) had a readmission or ED visit after 30 days. Of these 28, 4 patients had been to an ER within 7 days of EMU discharge. On univariate statistical analysis, charity or self-pay insurance status (p< 0.01), homelessness (p< 0.01), history of a psychiatric diagnosis (p< 0.02) and ED encounters 12 months prior to admission (p< 0.01) were significantly associated with readmission.
Clinical Epilepsy