Table 2. Clinical Characteristics of Admissions for FNDs vs Other Neurological Disorders in Adult and Pediatric Populations and Inpatient Health Care Resource Usea.
| Variable | Adult ≥18 y (2017 NIS) subpopulation (n = 30 420 907) | Pediatric 5-17 y (2016 KID) subpopulation (n = 965 132) | ||||||
|---|---|---|---|---|---|---|---|---|
| FND admissions, No./total No. (%) (n = 22 895) | Non-FND admissions, No./total No. (%) (n = 4 919 614) | P value | FND admissions, No./total No. (%) (n = 1264) | Non-FND admissions, No./total No. (%) (n = 124 053) | P value | |||
| Age, median (IQR), y | 45.48 (31.61-59.47) | 66.34 (52.28-78.23) | <.001 | 14.16 (11.90-15.55) | 11.46 (7.51-14.58) | <.001 | ||
| Age category, y | ||||||||
| 5-12 | NA | NA | <.001 | 283 (22.4) | 67 750 (54.6) | <.001 | ||
| 13-17 | NA | NA | 981 (77.6) | 56 303 (45.4) | ||||
| 18-40 | 9080 (39.7) | 619 520 (12.6) | NA | NA | ||||
| 41-65 | 9810 (42.9) | 1 702 740 (34.6) | NA | NA | ||||
| >65 | 4005 (17.5) | 2 597 354 (52.8) | NA | NA | ||||
| Sex | ||||||||
| Female | 15 830/22 890 (69.2) | 2 704 474/4 919 464 (55.0) | <.001 | 928 (73.4) | 62 124/124 031 (50.1) | <.001 | ||
| Male | 7060 (30.8) | 2 214 989 (45.0) | 336 (26.6) | 61 907 (49.9) | ||||
| Race/ethnicity | ||||||||
| White | 14 545/21 960 (66.2) | 3 357 104/4 759 504 (70.5) | <.001 | 670/1147 (58.4) | 60 972/113 635 (53.7) | .07 | ||
| Black | 4350/21 960 (19.8) | 751 725/4 759 504 (15.8) | 233 (20.4) | 18 556/113 635 (16.3) | ||||
| Hispanic | 2015/21 960 (9.2) | 406 895/4 759 504 (8.6) | 186 (16.2) | 23 717/113 635 (20.9) | ||||
| Asian or Pacific Islander | 270/21 960 (1.2) | 97 425/4 759 504 (2.1) | 20 (1.8) | 3464/113 635 (3.1) | ||||
| Native American | 180/21 960 (0.8) | 25 355/4 759 504 (0.5) | ≤10 | 845/113 635 (0.7) | ||||
| Other | 600/21 960 (2.7) | 121 000/4 759 504 (2.5) | 27 (2.3) | 6081/113 635 (5.4) | ||||
| Admission type | ||||||||
| Nonelective or emergent | 19 445/22 845 (85.1) | 4 171 984/22 845 (85.0) | .86 | 1098/1262 (87.0) | 88 491/123 675 (71.6) | <.001 | ||
| Socioeconomic status | ||||||||
| Zip code income quartile, percentile | ||||||||
| 0-25th, Lowest | 7725/22 475 (34.4) | 1 491 575/4 836 553 (30.8) | <.001 | 335/1247 (26.9) | 33 807/122 007 (27.7) | .08 | ||
| 26th-50th | 6255/22 475 (27.8) | 1 284 155/4 836 553 (26.6) | 323/1247 (25.9) | 29 391/122 007 (24.1) | ||||
| 51st-75th | 5085/22 475 (22.6) | 1 129 539/4 836 553 (23.4) | 335/1247 (26.9) | 30 142/122 007 (24.7) | ||||
| 76th-100th, Highest | 3410/22 475 (15.2) | 931 284/4 836 553 (19.3) | 254/1247 (20.4) | 28 667/122 007 (23.5) | ||||
| Psychiatric comorbidity | ||||||||
| Any psychiatric disorder | 14 885 (65.0) | 1 746 705 (35.5) | <.001 | 767 (60.7) | 19 736 (15.9) | <.001 | ||
| Mood disorder | 10 845 (47.4) | 1 224 550 (24.9) | <.001 | 452 (35.7) | 12 493 (10.1) | <.001 | ||
| Anxiety disorders | 9055 (39.6) | 906 320 (18.4) | <.001 | 549 (43.4) | 12 067 (9.7) | <.001 | ||
| Associated functional conditions | ||||||||
| FSDs | 2395 (10.5) | 201 375 (4.1) | <.001 | 85 (6.7) | 1500 (1.2) | <.001 | ||
| Length of stay | ||||||||
| Mean (SEM), d | 5.21 (0.15) | 6.03 (0.03) | <.001 | 4.01 (0.31) | 5.84 (0.10) | <.001 | ||
| Use of hospital services | ||||||||
| All rehabilitation services (PT/OT/speech, etc) | 140 (0.6) | 66 605 (1.4) | <.001 | ≤10 | 1034 (0.8) | .51 | ||
| PT | 130 (0.6) | 64 300 (1.3) | <.001 | ≤10 | 985 (0.8) | .61 | ||
| OT | 85 (0.4) | 46 815 (1.0) | <.001 | ≤10 | 622 (0.5) | .77 | ||
| SLP management | ≤10 | 23 840 (0.5) | <.001 | ≤10 | 355 (0.3) | .79 | ||
| Psychiatric management | 165 (0.7) | 18 180 (0.4) | .02 | ≤10 | 535 (0.4) | .23 | ||
| Psychiatric consultation | 60 (0.3) | 8515 (0.2) | .38 | ≤10 | 291 (0.2) | .34 | ||
| Workup | ||||||||
| All radiology | 1460 (6.4) | 549 760 (11.2) | <.001 | 53 (4.2) | 9658 (7.8) | <.001 | ||
| Neuroradiology | 245 (1.1) | 55 195 (1.1) | .75 | 40 (3.1) | 4407 (3.6) | .47 | ||
| CT head | ≤10 | 11 175 (0.2) | .05 | ≤10 | 428 (0.3) | .12 | ||
| CT spine | ≤10 | 215 (0.0) | .20 | 0 | ≤10 | .049 | ||
| MRI head | 70 (0.3) | 21 410 (0.4) | .15 | 34 (2.7) | 3524 (2.8) | .74 | ||
| MRI spine | 0 | 620 (0.0) | <.001 | ≤10 | 259 (0.2) | .04 | ||
| EEG or EEG LTM | 2700 (11.8) | 84 355 (1.7) | <.001 | 264 (20.9) | 14 391 (11.6) | <.001 | ||
| Lumbar puncture | 630 (2.8) | 108 615 (2.2) | .03 | 59 (4.6) | 7386 (6.0) | .08 | ||
| Discharge disposition | ||||||||
| Home | 14 400 (62.9) | 2 204 615 (44.8) | <.001 | 1136 (89.9) | 109 180 (88.0) | <.001 | ||
| Transfer to other facility or rehabilitation | 4270 (18.7) | 1 511 115 (30.7) | 83 (6.7) | 4813 (3.9) | ||||
| Home with home health care | 2935 (12.8) | 856 615 (17.4) | ≤10 | 6539 (5.3) | ||||
| Against medical advice | 625 (2.7) | 67 320 (1.4) | ≤10 | 137 (0.1) | ||||
| Died | 210 (0.9) | 151 070 (3.1) | <.001 | ≤10 | 929 (0.8) | <.001 | ||
| Primary insurance payer | ||||||||
| Medicare | 8690/22 835 (38.1) | 3 109 509/4 912 168 (63.3) | <.001 | 0 | 409/123 820 (0.3) | <.001 | ||
| Medicaid | 6465/22 835 (28.3) | 689 764/4 912 168 (14.0) | 613/1262 (48.6) | 62 984/123 820 (50.9) | ||||
| Private insurance | 5475/22 835 (24.0) | 865 145/4 912 168 (17.6) | 567/1262 (44.9) | 52 415/123 820 (42.3) | ||||
| Self-pay | 1285/22 835 (5.6) | 125 040/4 912 168 (2.6) | 26/1262 (2.1) | 1901/123 820 (1.5) | ||||
| No charge | 75/22 835 (0.3) | 11 115/4 912 168 (0.2) | 0 | 68/123 820 (0.1) | ||||
| Other | 845/22 835 (3.7) | 111 595/4 912 168 (2.3) | 56/1262 (4.5) | 6043/123 820 (4.9) | ||||
Abbreviations: CT, computed tomography; EEG, electroencephalography; EEG LTM, electroencephalography long-term monitoring/continuous video monitoring; FNDs, functional neurological disorders; FSDs, functional somatic disorders (irritable bowel syndrome, unexplained chronic pain, chronic fatigue, etc); IQR, interquartile range; KID, Kids’ Inpatient Database; MRI, magnetic resonance imaging; NA, not applicable; NIS, National (Nationwide) Inpatient Sample; OT, occupational therapy; PT, physical therapy; SLP, speech and language pathology.
Where applicable, data are presented with a weighted estimate sample (No.) and corresponding percentage of total (column %) or are otherwise described in parentheses based on nonmissing data. Unweighted value number is not shown; in cases in which the unweighted number is 10 or less, the weighted numbers are not available (denoted by ≤10). P values were calculated by t tests for continuous variables and by χ2 tests for categorical variables. In some cases, the totals for each variable do not sum to the heading totals owing to missing data, which is explained in eTable 3 in the Supplement.