Objective: To better understand the causes of acute illness and its consequences for subsequent inpatient care in patients with Huntington’s Disease (HD).

Background: HD is a genetic neurodegenerative disorder that is slowly progressive and thus primarily managed in the outpatient setting. There is little understanding of the outcomes of hospitalization in patients with HD. Drawing from a large national database of patients hospitalized in the United States, this study sought to understand the causes and outcomes of hospitalization in this patient population.

Methods: The Nationwide Inpatient Sample (NIS) data sets from 2003 to 2013 were used to identify HD patient admissions based on presence of ICD-9-CM code 333.4 as well as the associated diagnoses of each admission. These cases were grouped by primary diagnosis as cause for admission based on Clinical Classification Software (CCS) codes. Patients were also stratified by known source of admission and subsequent discharge disposition.

Results: From 2003 to 2013 as reported in the NIS, there were 6,913 patients with a diagnosis of HD in this analysis. Primary diagnoses on admission due to infectious and respiratory diagnoses were most common (20.5% and 18.2% respectively) with a large proportion of psychiatric diagnoses (12.9%) as well [table1]. 50.5% of all HD patient admissions had a discharge to either skilled nursing facility (SNF) or nursing home/long-term care facility (LTCF). Of all HD elective admissions, only 40.2% were discharged home or similar level of care [table2].

Conclusions: Despite its slow progression, HD remains a highly morbid condition, prone to multiple complications often leading to hospitalization. Primary reasons for admission are more likely to be medical than neuropsychiatric.  Despite this, hospitalization of HD patients is very likely to result in discharge to SNF/LTCF. Compared to a prior examination of these trends from 1996 to 2002, there are higher rates of hospitalization resulting in long term care placement, though slightly decreased mortality in the current sample[1]. This study reinforces the need for better understanding of factors leading to hospitalization of HD patients and also design better measures to delay or prevent LTCF placement and improve overall quality of life.

References: 1. Dubinsky, R.M., No going home for hospitalized Huntington’s disease patients. Mov Disord, 2005. 20(10): p. 1316-22.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/admission-diagnoses-and-eventual-discharge-dispositions-for-hospitalized-huntingtons-disease-patients-results-of-a-nationwide-survey/