好色先生

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Abstract Details

Predictors of 30-Day Hospital Readmission Following Acute Stroke
Cerebrovascular Disease and Interventional Neurology
S32 - (-)
006
30-day hospital readmission will soon be used to measure quality of care. Whether characteristics of patients at high risk of readmission can be identified prior to discharge is uncertain.
We designed a retrospective case-control study. Patients with acute ischemic or hemorrhagic strokes readmitted to an academic center within 30 days of discharge over an 18 month period were identified (cases) and compared to diagnosis-matched controls, not readmitted over this period. Demographic and clinical information (e.g. number of prior hospitalizations, admission NIH stroke scale) were collected. Descriptive analyses were performed using Chi-square and Wilcoxon tests. Multivariate stepwise logistic regression was used to identify variables associated with 30-day readmission.
The cohort included 198 patients (93 cases, 105 controls). Age, gender, and race did not differ between groups. Median time to readmission was 10 days (IQR 5 to 17). Readmission diagnoses included ischemic stroke (21.5%), infection (11%), and cardiac dysfunction (10%). Readmitted patients were more likely to have been hospitalized 2 or more times in the year prior to stroke (22.6% vs 4.8% in controls, p=0.0007). History of congestive heart failure (CHF) and pneumonia during the incident admission were associated with readmission (p=0.0097 and 0.033, respectively). The multivariate model showed that admission NIHSS (OR 1.056, 95% CI 1.010-1.103 per 1 point increase; p=0.015), prior hospitalizations (OR 1.754, 1.258-2.446 per additional admission; p=0.0009), and absence of hyperlipidemia (OR 0.501, 0.267-0.940; p=0.031) were independently associated with readmission.
Admission NIHSS and frequent hospitalizations prior to a stroke are associated with subsequent 30-day readmission following acute ischemic or hemorrhagic stroke. Although this model requires validation, the clinical characteristics identified in this study can be used to target high-risk patients and reduce readmission.
Authors/Disclosures
Starla Wise, DO (University of Cincinnati)
PRESENTER 		Dr. Wise has nothing to disclose.
Roy E. Strowd III, MD, FAAN (Wake Forest School Of Medicine) Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. The institution of Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SpringWorks . Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.
Laura Bishop, DO (eviCore Healthcare) No disclosure on file
No disclosure on file
Jeffrey Craig, MD (Wake Forest Univ Sch of Medicine) No disclosure on file
David S. Lefkowitz, MD (Wake Forest Baptist Health) No disclosure on file
Patrick S. Reynolds, MD, FAAN (Wake Forest University Health Sciences) Dr. Reynolds has nothing to disclose.
Martinson K. Arnan, MD, FAAN Dr. Arnan has nothing to disclose.
Cheryl Bushnell, MD, MHS (Wake Forest School of Medicine) Dr. Bushnell has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ZZ Biotech. The institution of Dr. Bushnell has received research support from PCORI. The institution of Dr. Bushnell has received research support from AHRQ. The institution of Dr. Bushnell has received research support from NIH/NINDS. Dr. Bushnell has received intellectual property interests from a discovery or technology relating to health care. Dr. Bushnell has received publishing royalties from a publication relating to health care.
Erik Wallstroem, MD, PhD (Sanofi) Dr. Wallstroem has received personal compensation for serving as an employee of Sanofi. Dr. Wallstroem has stock in Sanofi. Dr. Wallstroem has received intellectual property interests from a discovery or technology relating to health care.