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Having Migraine Puts Patients at Risk of Postsurgery Readmission

Jaime Rosenberg
Despite patients with migraine being younger and having fewer indicators for predicting readmission, they had an increased risk of 30-day hospital readmission due to pain.
Patients with migraine undergoing surgery are at an increased risk of 30-day hospital readmission due to pain, according to a new study. The risk was increased even more among patients who have migraine with aura.

This increased risk persisted despite those with migraine being younger and having fewer indicators for predicting readmission.

“Patients with migraine have been shown to experience an altered perception and processing of pain and allodynia to be common, particularly in patients with chronic migraine and migraine with aura,” noted the researchers.
The study looked at patient data on file at Massachusetts General Hospital, as well as 2 community hospitals in the state, and identified 150,710 surgical cases between January 2007 and December 2015.

Of the surgical cases, 11,768 (7.8%) had migraine, and among those with migraine, 1540 (13.1%) had migraine with aura. Those with migraine were younger and more often female, which is consistent with data that over 75% of the 38 million people in the United States who experience migraine are women. There were fewer emergency procedures, intensive care unit stays, and adverse discharges among those with migraine. There was also a lower prevalence of comorbidities among these patients.

Despite the lower prevalence of these indicators for readmission, those with migraine were more likely to have a 30-day hospital readmission after surgery. In total, 871 (0.6%) patients were readmitted with an admitted diagnosis specifying pain within 30 days. Of those, 109 were patients with migraine, representing 0.9% of patients with migraine in the study. At nearly half the rate, 0.5% of patients without migraine were readmitted within 30 days.

The adjusted predicted risk gave more insight, yielding results that showed that those with migraine with aura had the highest risk. Whereas those with no history of migraine had an adjusted predicted risk of 4.2 of 1000, those with migraine had an adjusted predicted risk of 5.9 of 1000, and those with migraine with aura had a significantly higher predicted risk of 9.1 of 1000.

Taking a look at the pain behind the readmission, researchers observed that 68.8% of patients with migraine were readmitted due to migraine-related pain—headache or abdominal pain.

Although 23.1% of patients with migraine received a prescription for triptans or ergotamine prior to surgery, the treatments did not significantly affect the risk of 30-day readmission due to pain. The same was seen among the 48.3% that had a prescription for migraine prophylactic medication.

 
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