Seizure comorbidity boosts odds of 30-day readmission after an index hospitalization for sepsis.

The objective of this study was to evaluate the association between comorbid seizures and hospital readmissions within 30 days following an index hospitalization for sepsis.We analyzed data from 445,489 adult discharges derived from the 2014 National Readmission Database, to evaluate the association of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis of seizure during an index hospitalization for sepsis and 30-day readmission rates. We excluded patients who died during hospitalization and those who had missing information on the length of stay or were discharged in December 2014. Prespecified groups were compared by their 30-day readmission and seizure status. We applied a multivariable logistic regression analysis to assess the independent association between seizure and readmission.Nearly one out of 15 patients discharged with a primary diagnosis of sepsis had comorbid seizures, of which 97% were status epilepticus. Patients with sepsis and comorbid seizures were 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures. Additional factors associated with a significantly higher risk for hospital readmission included male sex, age 45-84 years, increased length of stay and cost of primary admission, greater medical comorbidities, and discharge destination. Patients with seizures during their index hospitalization were significantly more likely to have also had a concurrent stroke or the central nervous system (CNS) infection compared with patients without seizures.Seizures are not uncommon, and patients with sepsis and comorbid seizures are 30% more likely to be readmitted within 30-days postdischarge, compared to those with sepsis and no comorbid seizures.