Abstract Details

Title Factors Affecting Readmission Rates for Patients with Ischemic Stroke Hospitalized in an Integrated Health System of Stroke Care

Topic Cerebrovascular Disease and Interventional Neurology

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

Poster/Presentation
Number 3-033

Objective We looked for factors associated with hospital readmission rates in patients diagnosed with ischemic stroke.

Background The Stroke Program Quality Initiative developed a MIDAS™ report of all inpatient encounters to all hospitals within an integrated health system within 30 days of a stroke discharge. A focus study guided a detailed case review including demographics, index admission stroke subtype, discharge treatment and disposition, readmission diagnosis, and location.

Design/Methods The analysis included 1843 stroke discharges from June 2016 to May 2018. The dependent variable was readmission to the hospital within 30 days. Characteristics were compared between patients that were not readmitted versus patients that were readmitted using odds ratios (OR).

Results The 30-day all-cause readmission rate was 13%; 14% at the comprehensive stroke center and 10 to 16% at the primary stroke centers. The principle diagnoses for readmission were sepsis/infection (14%), recurrent stroke (13%), and cardiovascular events (7.3%). Mean time between admissions was 10 days. Of the readmitted patients, 30% were admitted to a different facility than their initial admission. Patients receiving either tissue plasminogen activator (tPA) or mechanical thrombectomy were associated with decreased readmission rates (OR 0.5). Higher readmission rates were associated with length of stay (Overall OR 2.3; individual facilities (IF) ORs 2.1, 1.6, 2.2, 2.3, 3.5), females (Overall OR 1.3; IF ORs 1.3, 1.3, 1.3, 0.68, 0.69), age > 75 (Overall OR 1.5; IF ORs 1.8, 1.6, 1.7, 1.8, 1.7), and patients discharged to a skilled nursing facility (Overall OR 1.3; IF ORs 1.5, 0.94, 1.3, 0.98, 0.57). Widows and divorced patients had an overall OR of 1.5.

Conclusions A combination of demographic and disposition factors can consistently predict higher readmission rates amongst ischemic stroke patients within a large hospital system that shares a cohesive stroke care policy amongst the individual facilities. Acute treatments with either tPA or mechanical thrombectomy were protective.

Authors/Disclosures
Scott M. Le, DO PRESENTER	No disclosure on file
	No disclosure on file
Cathy A. Sila, MD, FAAN (Neurological Institute Cleveland Medical Center)	Dr. Sila has nothing to disclose.

��ɫ��

��ɫ��