Increased risk of hospital admission for mood disorders following admission for epilepsy
Increased risk of hospital admission for mood disorders following admission for epilepsy
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DOI：
10.1212/01.wnl.0000542492.00605.9d
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发表时间：
2018-08-28
期刊：
影响因子：
9.9
通讯作者：
Dhamoon, Mandip S.
中科院分区：
文献类型：
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作者：
Kim, Anna M.;Rossi, Kyle C.;Dhamoon, Mandip S.
Objectives确定癫痫入院，相比其他医疗原因的入院，与较高的再入院风险为mood disorders.MethodsThe Nationwide Recommissions Database是一个全国代表性的数据集，包括49%的美国住院治疗，在2013年。在这项回顾性队列研究中，我们使用ICD-9-CM编码来识别医疗条件。将癫痫指数入院（n = 58，278）与卒中指数入院（n = 215，821）和常见医学原因（n = 973，078）进行比较。计算出院后90天内抑郁症或双相情感障碍的再入院率（每100，000例指数入院）。考克斯回归用于检验入院类型之间的关联（定义为上述3个类别）和索引入院后1年内因抑郁症或双相情感障碍再次入院，在单变量模型中，并根据年龄、性别、精神病史、药物滥用、患者邮政编码的收入四分位数进行调整，结果调整后的风险比（HR）癫痫组因抑郁症再入院的比例比卒中组高2.80（95%置信区间[CI] 2.39-3.27，p < 2 x 10（-16）），与药物组相比为2.09（95% CI 1.88-2.32，p < 2 x 10（-16））。与卒中组相比，癫痫组因双相情感障碍再入院的校正HR升高至5.84（95% CI 4.56-7.48，p < 2 x 10（-16）），与药物组相比为2.46（95% CI 2.16-2.81，p < 2 × 10（-16））。结论癫痫入院与随后因情绪障碍再次入院独立相关。这一人群中风险升高的程度表明，癫痫患者在住院期间可能需要进行有针对性的精神病筛查。
ObjectiveTo determine if epilepsy admissions, compared to admissions for other medical causes, are associated with a higher readmission risk for mood disorders.MethodsThe Nationwide Readmissions Database is a nationally representative dataset comprising 49% of US hospitalizations in 2013. In this retrospective cohort study, we used ICD-9-CM codes to identify medical conditions. Index admissions for epilepsy (n = 58,278) were compared against index admissions for stroke (n = 215,821) and common medical causes (n = 973,078). Readmission rates (per 100,000 index admissions) for depression or bipolar disorders within 90 days from discharge for index hospitalization were calculated. Cox regression was used to test for associations between admission type (defined in 3 categories as above) and readmission for depression or bipolar disorder up to 1 year after index admission, in univariate models and adjusted for age, sex, psychiatric history, drug abuse, income quartile of patient's zip code, and index hospitalization characteristics.ResultsThe adjusted hazard ratio (HR) for readmission for depression in the epilepsy group was elevated at 2.80 compared to the stroke group (95% confidence interval [CI] 2.39-3.27, p < 2 x 10(-16)), and 2.09 compared to the medical group (95% CI 1.88-2.32, p < 2 x 10(-16)). The adjusted HR for readmission for bipolar disorder in the epilepsy group was elevated at 5.84 compared to the stroke group (95% CI 4.56-7.48, p < 2 x 10(-16)), and 2.46 compared to the medical group (95% CI 2.16-2.81, p < 2 x 10(-16)).ConclusionAdmission for epilepsy was independently associated with subsequent hospital readmission for mood disorders. The magnitude of elevated risk in this population suggests that patients admitted with epilepsy may warrant targeted psychiatric screening during their hospital admission.