Abstracts

Rationale: In USA, about one in 5 hospitalized patients was readmitted to hospital within 30 days. Centers for Medicare and Medicaid (CMS) have started a program aimed at reducing hospital 30-day readmissions. Patients with seizures/epilepsy have higher risk for 30-day readmission. Very few studies involving the risk factors for 30 day readmission in seizure/epileptic patients were reported. The purpose of this study is to identify the risk factors and profile review for 30 days readmission in epilepsy patients in a level 4 epilepsy center.Methods: A retrospective case study was conducted. 96 adult cases (88 patients) were identified as 30-day readmission in the period from January 2011 to December 2013. Data collected from the chart include: demographics, number of 30-day readmissions, seizure type(s), the reasons for readmission, and other factors potentially contributing to the readmission.Results: In 49 of the 96 cases (51%), the reasons for readmission were not directly seizure/epilepsy related. They include: 5/49 surgical admission (non-seizure related), 14/49 non epileptic psychogenic events, and 30/49 other medical reasons (dehydration, cancer, chest pain, sepsis, etc.). 47 of 96 cases (49%) were readmitted directly related to seizure/epilepsy. They include: 42/47 recurrent seizures, 1/47 seizure related complications (aspiration pneumonia), 1/47 toxic effects from AEDs, and 3/47 elective Epilepsy Monitoring Unit (EMU) admission. Regarding the seizure types, among these 47 cases with readmission directly related to seizures/epilepsy. 35/47 were focal onset seizures, 1 simple partial seizure (SPS), 7 complex partial seizures (CPS), 4 secondary generalized tonic clonic seizures (GTCS), 23 CPS and secondary GTCS; 3/47 were primary generalized epilepsy with absence and GTCS; 9/47 were unclassified. 33/47 (70%) cases had medically refractory epilepsy.Conclusions: Only 49% of the patients, in our study group, the reasons for 30-day readmission were directly seizure/epilepsy related. The majority of the patients had medically refractory, focal onset epilepsy, and they were readmitted due to recurrent seizures.