Abstract Details

Title Predictors and Outcomes of 30-Day Readmissions in Patients Hospitalized for Acute Ischemic Stroke Undergoing Mechanical Thrombectomy

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 5-020

Objective We evaluated the 30-day all-cause readmission rate and identified independent demographic and clinical predictors of readmissions among AIS patients undergoing Mechanical thrombectomy (MT).

Background Acute ischemic stroke (AIS) is a medical emergency with a mortality rate of 19.06 per 100,000 person-years. MT following AIS improves clinical outcomes but lacks data for its short-term readmission outcomes.

Design/Methods Using the Nationwide Readmissions Database (2016–2017), we identified adult patients hospitalized for AIS who underwent MT. Outcomes included 30-day all-cause readmission, in-hospital mortality, length of stay (LOS) and inflation-adjusted hospitalization charges. Weighted baseline characteristics of index hospitalizations were stratified by readmission status. Independent predictors of readmission were identified using multivariable Cox proportional hazards regression and reported as hazard ratios (HRs) with 95% confidence intervals (CI).

Results Among 29,783 AIS index hospitalizations, 8.9% (n= 2,676) experienced a 30-day non-elective readmission, most commonly due to cerebral infarction (14.15%) and sepsis (13.72%). Readmitted patients were predominantly aged 65-79 (40%) and female (52.0%). Compared with non-readmitted patients, they more frequently had Medicare insurance (70.0% vs. 63.0%; p<0.004), were discharged to non-home settings (63.0% vs. 58.0%; p<0.001), and exhibited a greater comorbidity burden (p<0.001), particularly arrhythmia, congestive heart failure, diabetes, coronary artery disease (CAD), fluid/electrolyte imbalance, chronic pulmonary disease, renal disease and valvular disease. The mean LOS was longer during index admission than readmission (11.6 vs 6.9 days), with higher corresponding hospitalization charges ($203,889 vs $65,778) and in-patient mortality rate (14.2% vs 6.4%). Independent predictors of readmission included comorbid renal disease, CAD, and fluid/electrolyte imbalance (p<0.05).

Conclusions Nearly 1 in 10 AIS patients undergoing MT was readmitted within 30 days, most commonly due to cerebral infarction and sepsis. Renal disease, CAD, and fluid/electrolyte imbalance predicted early readmission. Improved post-discharge management addressing comorbidities may reduce preventable readmissions and mitigate the clinical and economic burden of AIS.

Authors/Disclosures
Khadija Tanvir, MBBS PRESENTER	Dr. Tanvir has nothing to disclose.
Adeena Jamil, MBBS	Dr. Jamil has nothing to disclose.
Eliza Aisha	Ms. Aisha has nothing to disclose.
Khadija Alam	Khadija Alam has nothing to disclose.
Fatima Awais, MBBS	Dr. Awais has nothing to disclose.
Rana Faheem U. Khan, MBBS	Dr. Khan has nothing to disclose.
Hadiya Javed, MBBS	Ms. Javed has nothing to disclose.
Syeda T. Fatima	Syeda T. Fatima has nothing to disclose.
Yusra Rizwan, MBBS	Dr. Rizwan has nothing to disclose.
Sabeeh K. Farooqui, MBBS	Dr. Farooqui has nothing to disclose.
Ezza Bashir, MD	Dr. Bashir has nothing to disclose.
Tipu Sultan, MBBS	Prof. Sultan has nothing to disclose.
Hafiz Muhammad Usama Javed, MBBS	Dr. Javed has nothing to disclose.
Hafiz Muhammad Sameer, MBBS	Dr. Sameer has nothing to disclose.

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