Abstract Details

Title Higher In-Hospital Mortality, Length of Stay, and 30-day Readmission Rates among Stroke Patients with Delirium: A Population based Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-027

Objective Provide nationwide estimates and trend for delirium among stroke patients (SPs), characterize SPs with delirium, and compare in-hospital and readmission outcomes between delirium and non-delirium SPs.

Background Delirium among critically ill patients results in poor outcomes. However, such evidence is lacking for SPs.

Design/Methods We analyzed the National Readmission Database (2010 – 2015) and identified patients with ischemic (IS) and hemorrhagic stroke (HS) (intracerebral and sub-arachnoid hemorrhage) using validated ICD-9 codes. Patients were followed-up for 30-day-readmission. Delirium was identified using published algorithms. We used survey-design logistic regression to provide national estimates of proportions and 95% confidence intervals (CI), and odds ratios (OR) for association between delirium and poor outcomes.

Results We identified 2,078,854 unique stroke discharges with 6.58% coded to have delirium. This proportion significantly increased between 2010 (5.5%) and 2015 (7.7%), OR: 1.08 (1.07 – 1.09). Delirium proportion was higher among HS (ICH: 9.9%, SAH: 8.9%) as compared to IS patients (6.2%). Females and elderly patients had a higher likelihood of delirium after adjustment for co-morbidities. At the index hospitalization, SPs with delirium had longer in-hospital stay (9.0 vs. 5.3 days) and higher mortality (12.5% vs. 8.2%) as compared to non-delirium SPs. Patients with delirium also had a significantly higher adjusted risk of 30-day-readmission (15.6%) as compared to non-delirium SPs (11.2%), OR: 1.10 (1.07-1.13). Upon readmission, patients with delirium at initial admission, continued to have longer hospital stay (7.7 vs. 6.6 days) and higher mortality (9.3% vs. 6.4%).

Conclusions Nationally, the reported proportion of SPs with in-hospital delirium has increased but may still be under-reported. Sex and age disparities for delirium may exist. Delirium is independently associated with poor in-hospital outcomes both at index admission and readmission. Delirium patients have a 10% higher adjusted risk of 30-day-readmission. Biological pathways connecting delirium with poor outcomes among SPs need to be identified.

Authors/Disclosures
Farhaan S. Vahidy, MBBS, PhD (Houston Methodist) PRESENTER	Dr. Vahidy has nothing to disclose.
	No disclosure on file
Jennifer Meeks	No disclosure on file
	No disclosure on file
Alicia Zha, MD (The Ohio State University Wexner Medical Center)	The institution of Dr. Zha has received research support from ��ɫ��. The institution of Dr. Zha has received research support from American Board of Psychiatry and Neurology.
	No disclosure on file

��ɫ����

��ɫ����

��ɫ��

��ɫ��