Abstract Details

Title Predictors of 30 Day Readmission after Intracranial Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S09 - (-)

Poster/Presentation
Number 006

Objective

Background Readmission within 30 days is a metric of healthcare quality. Predictors of readmission in ICH are largely unknown.

Design/Methods We prospectively collected demographic, clinical, and hospital course data for consecutive patients hospitalized with ICH and identified patients re-admitted within 30 days of discharge by an automated query with medical record confirmation. We identified categories of readmission diagnoses and investigated key variables for association with readmission. We investigated potential associations between readmission and functional outcomes using modified Rankin Scale (mRS, a validated measure of functional outcome from 0, no symptoms to 6, death) scores before ICH and at 14, 28, and 90 days after ICH.

Results Of 246 patients (mean age 65 years, 51% female, median ICH score 1, median admission NIHSS 11), 193 survived to discharge. 22 (11%) were re-admitted within a median of 9 (IQR 4-15) days. The most common readmission diagnoses were new infections (N=10) and vascular events (N=6). Age; history of stroke, coronary artery disease, and hypertension; admission NIHSS and ICH score; ICU and hospital length of stay; ventilator free days; days febrile; tracheostomy and gastrostomy tube placement; and craniotomy and extraventricular drain placement were not predictors of readmission. mRS at 14 days was not different between patients who were re-admitted versus those who were not but there were higher (worse) 90 day mRS scores (median 5 [IQR 3-6] vs. 3 [IQR 1-5], p=0.01) in those readmitted within 30 days.

Conclusions Severity of illness and demographic variables were not associated with 30-day readmission. The most common indication for readmission was new infection and readmission was associated with worse 90 day outcomes. It may be difficult to predict readmission after ICH and prevention may be largely dependent on optimizing care after discharge.

Authors/Disclosures
Eric Liotta, MD (Northwestern University) PRESENTER	Dr. Liotta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Penumbra. The institution of Dr. Liotta has received research support from NIH-NINDS.
	No disclosure on file
James Guth, MD	No disclosure on file
	No disclosure on file
Shyam Prabhakaran, MD (University of Chicago)	Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. Dr. Prabhakaran has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Cincinnati. The institution of Dr. Prabhakaran has received research support from NIH . The institution of Dr. Prabhakaran has received research support from AHRQ. Dr. Prabhakaran has received publishing royalties from a publication relating to health care.
Neil Rosenberg, MD (Rosenberg Medical, PLLC)	Dr. Rosenberg has nothing to disclose.
Steven Galetta, MD, FAAN (NYU Langone Medical Center)	Dr. Galetta has nothing to disclose.
Matthew Maas, MD, FAAN (Northwestern University)	The institution of Dr. Maas has received research support from National Institutes of Health.
Andrew M. Naidech, MD, FAAN (Department of Neurology)	The institution of Dr. Naidech has received research support from NIH. Dr. Naidech has received publishing royalties from a publication relating to health care.

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