Twelve-year proportions and causes of admissions among those with neurological conditions in the US: A nationally representative study

Abstract

Objectives: Understanding admission trends and causes is essential for optimal healthcare allocation and targeted interventions to prevent hospitalizations. This study investigates hospital admissions proportions and primary causes among patients with the following neurological conditions: Brain tumors (BT), motor neuron disease (MND), multiple sclerosis (MS), Parkinson's disease (PD), spinal cord injury (SCI), traumatic brain injury (TBI), stroke, cerebral palsy (CP).

Methods: We conducted a retrospective analysis using the National Inpatient Sample (2003-2014), identifying patients of all ages with validated ICD-9-CM codes for these neurological conditions in any diagnostic position. Admission causes were identified using Clinical Classifications Software for Diagnosis Codes. Weighted proportions of admission and top three causes of admissions were calculated for each diagnosis.

Results: The eight neurological conditions accounted for 8.11 % of all admissions in 2003, increasing to 9.37 % in 2014. Admissions for all conditions, except PD, increased proportionally. Stroke showed the largest absolute increase (13.62 %). For BT, MND, MS, SCI and TBI, the top cause of admission remained the neurological condition itself, but this percentage decreased over time. The top cause of admission changed from epilepsy/convulsions (2003-2012) for CP, and pneumonia (2003-2008) for PD, to septicemia for both conditions in subsequent years. Notably, from 2011 to 2014 septicemia was among the top three causes of all hospital admissions across diagnoses, except for BT and TBI.

Discussion: Seven of the conditions of interest had one or more top causes of admission that were potentially preventable. Further emphasis on infection prevention is likely to reduce the occurrence of admission in those with neurological conditions.

Keywords: Administrative data; Clinical modification; Hospital admissions; International Classification of Diseases; Neurology; Ninth revision.