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. 2024 Sep 23:14:47.
doi: 10.5334/tohm.934. eCollection 2024.

Reasons for Hospitalizations and Emergency Department Visits Among Patients with Essential Tremor

Susanna Howard  1 , Ellie Gabriel  2 , Ritesh Karsalia  2 , Dominick Macaluso  1 , Jesse Y Hsu  3 , Liming Qiu  1 , Neil R Malhotra  1 , Iahn Cajigas  1 , Whitley Aamodt  4 , John Farrar  3
Affiliations

Reasons for Hospitalizations and Emergency Department Visits Among Patients with Essential Tremor

Susanna Howard et al. Tremor Other Hyperkinet Mov (N Y). .

Abstract

Background: Prior studies suggest that patients with essential tremor (ET) have increased rates of healthcare utilization, but the reason for this increased use is unknown. The objective of this study was to evaluate the reasons for healthcare use among ET patients.

Methods: This was a retrospective cross-sectional study of ET patients with an admission or emergency department (ED) visit at a tertiary health system from 2018-2023. Patients were matched on an encounter level with control patients based on propensity scores incorporating age, sex, race, and co-morbid conditions. The primary outcome was the odds of an encounter for each diagnostic category comparing ET patients with matched controls.

Results: Only inpatient admissions for neurologic diagnoses were more likely for ET compared to control patients (odds ratio (OR) 3.73, 95% confidence interval (CI) 2.54 - 5.49, p < 0.001). Once admissions related to the surgical treatment of tremor were excluded, admissions for neurologic diagnoses were equally likely among ET and control patients (OR 0.96, 95% CI 0.59 - 1.57, p = 0.88).

Discussion: Surgical treatment of tremor appears to be a key driver of healthcare use among ET patients. Future investigations should examine the pattern of healthcare use of ET patients before and after surgery.

Highlights: Prior studies have shown increased healthcare use among essential tremor (ET) patients. The objective of this study was to evaluate the reasons for healthcare use among ET patients compared to matched control patients. Surgical treatment of tremor was found to be a key driver of healthcare use among ET patients.

Keywords: essential tremor; healthcare resource utilization.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Odds of inpatient admission associated with each diagnostic category among admissions of patients with essential tremor (ET) (n = 888) compared to matched admissions among control patients without ET (n = 888). Odds of ophthalmologic and wound-related admissions were omitted from the plot due to the CI widths. Due to multiple comparisons, statistical significance was defined as a p-value of less than 0.002. Abbreviations: CI confidence interval; SCI spinal cord injury; TBI traumatic brain injury
Figure 1
Odds of inpatient admission associated with each diagnostic category among admissions of patients with essential tremor (ET) (n = 888) compared to matched admissions among control patients without ET (n = 888). Odds of ophthalmologic and wound-related admissions were omitted from the plot due to the CI widths. Due to multiple comparisons, statistical significance was defined as a p-value of less than 0.002. Abbreviations: CI confidence interval; SCI spinal cord injury; TBI traumatic brain injury.
Odds of emergency department (ED) visits associated with each diagnostic category among ED visits of patients with essential tremor (ET) (n = 1,114) compared to matched control ED visits among patients without ET (n = 1,114). Odds of burn-related visits were omitted from the plot due to the CI width. Due to multiple comparisons, statistical significance was defined as a p-value of less than 0.002. Abbreviations: CI confidence interval; SCI spinal cord injury; TBI traumatic brain injury
Figure 2
Odds of emergency department (ED) visits associated with each diagnostic category among ED visits of patients with essential tremor (ET) (n = 1,114) compared to matched control ED visits among patients without ET (n = 1,114). Odds of burn-related visits were omitted from the plot due to the CI width. Due to multiple comparisons, statistical significance was defined as a p-value of less than 0.002. Abbreviations: CI confidence interval; SCI spinal cord injury; TBI traumatic brain injury.
See this image and copyright information in PMC

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