30-Day readmission rates in pediatric patients with functional seizures

Area of Science:

• Pediatric Neurology
• Epileptology
• Clinical Outcomes Research

Background:

• Functional seizures (FS) are common in pediatric neurology.
• Understanding readmission rates is crucial for optimizing care pathways.

Purpose of the Study:

• To determine 30-day readmission and emergency department (ED) presentation rates for pediatric patients with functional seizures.
• To identify factors associated with hospital revisits after discharge for functional seizures.

Main Methods:

• Retrospective chart review of 102 pediatric patients discharged for functional seizures.
• Data included demographics, comorbidities, risk factors, and treatments during the index admission.
• Analysis compared outcomes for patients admitted to the pediatric epilepsy monitoring unit (EMU) versus general neurology service.

Main Results:

• Nearly 20% of patients experienced a 30-day readmission or ED visit.
• Admission to the general neurology service was independently associated with increased hospital re-presentations (p < 0.0015).
• Cognitive impairment and autism correlated with lower readmission risk, while neurology referral and anti-seizure medication initiation correlated with higher risk.

Conclusions:

• A significant proportion of pediatric patients with functional seizures require re-hospitalization within 30 days.
• Epilepsy monitoring unit admissions appear to reduce readmission likelihood compared to general neurology services.
• Differences in patient characteristics and evaluation comprehensiveness between EMU and general neurology may explain outcome variations.