The association between migraine and hospital readmission due to pain after surgery: A hospital registry study.
Migraine
hospital readmission
pain
perioperative
surgery
Journal
Cephalalgia : an international journal of headache
ISSN: 1468-2982
Titre abrégé: Cephalalgia
Pays: England
ID NLM: 8200710
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
pubmed:
10
7
2018
medline:
14
4
2020
entrez:
10
7
2018
Statut:
ppublish
Résumé
Migraine has been identified as a risk factor of 30-day hospital readmission after surgery. We aimed to further characterize this association examining pain as a potentially migraine-associated, preventable reason for readmission. Compared to patients with no migraine, surgical patients with migraine are at increased risk of 30-day hospital readmission with an admitting diagnosis specifying pain. This hospital registry study examined 150,710 patients aged 18 years and above, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and two affiliated community hospitals in Massachusetts, USA. Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio 1.42 [95% confidence interval 1.15-1.75]). The association was stronger for migraine with aura (compared to migraine without aura: Adjusted odds ratio 1.69 [95% confidence interval 1.06-2.70]; compared to no migraine: Adjusted odds ratio 2.20 [95% confidence interval 1.44-3.37]). The predicted adjusted risk of pain-related 30-day readmissions was 9.1 [95% confidence interval 5.3-13.0] in 1000 surgical patients with migraine with aura and 5.4 [95% confidence interval 4.2-6.6] in 1000 patients with migraine without aura, compared to 4.2 [95% confidence interval 3.8-4.5] in 1000 patients with no migraine. Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted odds ratio 1.55 [95% confidence interval 1.20-2.00]). Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain.
Sections du résumé
BACKGROUND
Migraine has been identified as a risk factor of 30-day hospital readmission after surgery. We aimed to further characterize this association examining pain as a potentially migraine-associated, preventable reason for readmission.
HYPOTHESIS
Compared to patients with no migraine, surgical patients with migraine are at increased risk of 30-day hospital readmission with an admitting diagnosis specifying pain.
METHODS
This hospital registry study examined 150,710 patients aged 18 years and above, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and two affiliated community hospitals in Massachusetts, USA.
RESULTS
Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio 1.42 [95% confidence interval 1.15-1.75]). The association was stronger for migraine with aura (compared to migraine without aura: Adjusted odds ratio 1.69 [95% confidence interval 1.06-2.70]; compared to no migraine: Adjusted odds ratio 2.20 [95% confidence interval 1.44-3.37]). The predicted adjusted risk of pain-related 30-day readmissions was 9.1 [95% confidence interval 5.3-13.0] in 1000 surgical patients with migraine with aura and 5.4 [95% confidence interval 4.2-6.6] in 1000 patients with migraine without aura, compared to 4.2 [95% confidence interval 3.8-4.5] in 1000 patients with no migraine. Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted odds ratio 1.55 [95% confidence interval 1.20-2.00]).
CONCLUSION
Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain.
Identifiants
pubmed: 29984600
doi: 10.1177/0333102418786457
pmc: PMC7192134
mid: NIHMS1579507
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
286-295Subventions
Organisme : NINDS NIH HHS
ID : R01 NS094198
Pays : United States
Organisme : NINDS NIH HHS
ID : R37 NS079678
Pays : United States
Références
Ann Intern Med. 2009 Feb 3;150(3):178-87
pubmed: 19189907
Br J Anaesth. 2018 May;120(5):1090-1102
pubmed: 29661386
J Neurosci. 2015 Apr 29;35(17):6619-29
pubmed: 25926442
Pain Res Manag. 2011 May-Jun;16(3):183-6
pubmed: 21766068
J Anesth. 2017 Apr;31(2):225-236
pubmed: 27864621
Headache. 2012 Jan;52(1):18-36
pubmed: 22268775
BMC Health Serv Res. 2015 Sep 23;15:406
pubmed: 26399319
Headache. 2013 Jun;53(6):984-93
pubmed: 23721241
Cephalalgia. 2006 May;26(5):506-10
pubmed: 16674758
Am J Emerg Med. 2017 Dec;35(12):1845-1849
pubmed: 28645559
N Engl J Med. 2017 Sep 14;377(11):1055-1064
pubmed: 28902587
Clin Rheumatol. 2005 Nov;24(6):595-601
pubmed: 15902517
Neurology. 2004 May 25;62(10):1662-3
pubmed: 15159457
Neurology. 2016 May 10;86(19):1818-26
pubmed: 27164716
Ann Surg. 2018 Jun;267(6):1084-1092
pubmed: 28288059
J Trauma. 2009 Jun;66(6):1696-702; discussion 1702-3
pubmed: 19509634
Neurol Sci. 2012 May;33 Suppl 1:S9-11
pubmed: 22644161
Headache. 2007 Sep;47(8):1125-33
pubmed: 17883517
Ann Surg. 2005 Oct;242(4):463-8; discussion 468-71
pubmed: 16192806
Br J Anaesth. 1969 May;41(5):401-6
pubmed: 5772607
Br J Anaesth. 2001 Jul;87(1):88-98
pubmed: 11460816
Neurology. 2000 Sep 26;55(6):754-62
pubmed: 10993991
Anesthesiology. 2018 May;128(5):880-890
pubmed: 29470180
N Engl J Med. 2013 Sep 19;369(12):1134-42
pubmed: 24047062
Anaesthesia. 1970 Jul;25(3):334-40
pubmed: 5431057
Am J Med. 2012 Nov;125(11):1135-9
pubmed: 22939361
Cephalalgia. 2017 Apr;37(5):470-485
pubmed: 27837173
Neurology. 2017 Aug 1;89(5):461-468
pubmed: 28679597
Headache. 2015 Mar;55 Suppl 2:103-22; quiz 123-6
pubmed: 25662743
BMJ. 2017 Jan 10;356:i6635
pubmed: 28073753
J Headache Pain. 2011 Apr;12(2):115-25
pubmed: 21210177