Abstract WMP37: Burden of Neurological Complications Among Patients With Moyamoya Disease (MMD) Treated With Revascularization

Abstract

Introduction: Moyamoya disease is a chronic steno-occlusive vasculopathy involving the circle of Willis and typically presents with ischemic or hemorrhagic stroke. Prior studies suggest that either direct or indirect extracranial-intracranial bypass (EC-IC) is an effective treatment for MMD. However, the burden of post-discharge neurological complications after the procedure is unknown. Our study aims to identify the 90 readmission rate (90-DRR) and neurological complications upon readmission in revascularization and untreated MMD patients. Method: We analyzed the data from the Nationwide Readmission Database (NRD) from 2010-2015. MMD was ascertained by ICD-9 discharge code 437.5 and revascularization (EC-IC) using 39.28. SAS 9.4 was used for data analysis with categorical and continuous variables tested using the Rao Scott Chi-square test and Student’s t-test respectively. Result: Among total 4,902 MMD index events, 1,840 had a revascularization procedure and 3,062 did not. The 90-DRR for the treatment group was 14.72% (readmitted N=271/Index cases N=1,840) vs. 34.75% (readmitted N=1,064/Index cases N=3,062) for the non-revascularization group (P <0.0001). Baseline characteristics of MMD with revascularization were mean age (Mean±SE) 41±0.6 vs. 40±0.5 (P=0.20), Charlson comorbidity index (CCI) 1.6±0.04 vs. 1.8±0.05 (P=0.0004), female: male 3:1. Cause-specific readmission rate in both groups was reported as per table. Conclusion: Our analysis shows that patients treated with revascularization had significantly fewer 90-day readmissions when compared to untreated patients. MMD and ischemic stroke were the top reasons for readmission within the 90 days of discharge for both groups. A seizure was reported higher in the treatment group.