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.

中文翻译：

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脑外伤患者癫痫合并症与早期住院再住院的关系

摘要

目的

为了评估美国颅脑外伤（TBI）住院患者的癫痫合并症发病率及其与30天再入院率的独立相关性。

方法

数据来源是2014年全国再入院数据库。我们纳入了根据国际疾病分类第九次修订版临床修改（ICD-9-CM）代码800.0、801.9、803.0、804.9、850.0-854.1识别的，具有TBI初次出院诊断的成人（年龄≥18岁），和959.01。使用ICD-9-CM代码345.x和780.39诊断癫痫发作。总体上和在预先指定的组之间计算了30的再入院率。Logistic回归分析用于确定30天再入院的独立预测因素。

结果

在诊断为TBI的76062名未加权出院成人中，有7776名（10.14％）具有继发性癫痫发作的诊断。在30天内，共有1751名（2.3％）初发TBI诊断的患者再次入院。在多因素logistic分析中，与没有癫痫发作的患者相比，具有癫痫继发诊断的患者在30天之内再次入院的可能性要高18％（OR 1.18，95％CI：1.01-1.39，P = 0.42）。

结论

在美国，每10例接受TBI住院治疗的患者患有合并病性癫痫发作。癫痫合并症在30天内被再次录入的几率高18％。