Abstract TP322: Predictors of 90-day Hospital Readmission After Ischemic Stroke

• Published in: Stroke (1970) 2018-01, Vol.49 (Suppl_1)
• Main Authors: Chang, Andrew D, Dakay, Katarina, Hemendinger, Morgan, Cutting, Shawna M, Saad, Ali, Jayaraman, Mahesh V, McTaggart, Ryan A, Furie, Karen L, Yaghi, Shadi
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.49.suppl_1.TP322

Abstract only Background: Hospital readmissions carry significant burden on both patients and providers, and may be preventable by appropriate identification of high-risk patients. In this study, we aimed to identify factors predictive of hospital readmission following ischemic stroke. Methods: We abstracted data from our ischemic stroke database and included all patients with ischemic stroke from April 1 st , 2016 to March 31 st 2017. Follow-up information was obtained at 90 days and included whether patients had been readmitted to Rhode Island Hospital. Patients were divided into two groups - those who had been readmitted at 90 days vs. not readmitted at 90 days. We compared baseline demographics including age, vascular risk factors, NIHSS score, acute stroke treatment (mechanical thrombectomy and IV thrombolysis), stroke subtype determined based on ESUS criteria, and hospital acquired-infections, hospital readmission rate. Results: We identified 600 patients with ischemic stroke; 185 patients (30.8%) were readmitted at 90 days. On univariate analyses, readmitted patients were more likely to have a higher 24-hour NIHSS (3 vs 2; p=0.007), and more likely to have hypertension (82.0% vs 72.9%; p=0.021), atrial fibrillation (36.6% vs 23.8%; p=0.002), congestive heart failure (14.7% vs 5.8%; p=0.001), large vessel occlusion (54.5% vs 43.8%; p=0.033), and cardioembolic stroke subtype (36.4% vs 25.3%). Moreover, readmitted patients were less likely to have cryptogenic stroke subtype (31.8% vs 44.1%; p=0.006). On regression models, hypertension (adjusted OR 1.78; 95% CI 1.02-3.10, p=0.043), atrial fibrillation (adjusted OR 3.12; 95% CI 1.08-9.00, p=0.035), congestive heart failure (adjusted OR 2.80; 95% CI 1.29-6.06, p=0.009), and cardioembolic stroke subtype (adjusted OR 0.32; 95% CI 0.10-0.98, p=0.046) were predictive of hospital readmission at 90 days. Conclusion: Nearly 30% of patients admitted with ischemic stroke are re-admitted in the next 90 days. Efforts to identify causes of re-admission particularly among high risk patients are needed to reduce the re-admission rates among stroke patients.