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Abstract Details

Estimates And Temporal Trends For US Nationwide 30-day Hospital Readmission Among Patients With Ischemic Stroke Treated With Thrombolytic Therapy
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
055
To identify US nationwide estimates and a temporal trend for 30-day hospital readmissions
Avoidance of readmission is linked to improved quality of care, reduction in cost, and is a desirable patient-centered outcome. Nationally representative readmission metrics for patients with acute ischemic stroke treated with intravenous thrombolytic treatment (IV-tPA) are unavailable to date. Such estimates are necessary for benchmarking performance.
We identified the cohort by year-wise analysis of the Nationwide Readmissions Database between January 1, 2010, and September 30, 2015. The database represents 50% of all US hospitalizations from 22 geographically dispersed states. Participants were adult (=>18 years) patients with a primary discharge diagnosis of acute ischemic (ICD-9-CM 433.x1 and 434.x1) who were treated with thrombolytic therapy (ICD-9-CM 9910). Readmission was defined as any admission within 30 days of index hospitalization discharge.
Based on study criteria, 57,676 eligible patients were included (mean [SE] age, 68.7 ± 14.4 years; 48.7% were women). Thirty-day readmission rate for acute ischemic stroke patients treated with IV-tPA was 11.17 % (95%CI, 10.92 %-11.43%). On average, there was a 4.4% annual decline in readmission between 2010 and 2014, which was statistically significant for the period of investigation (odds ratio, 0.95; 95%CI, 0.94-0.97). Age ≥ 65 years (OR 1.16 P <.0001), medical history of congestive heart failure (OR 1.11 P = 0.0056), chronic lung disease (OR 1.11 P = 0.0034) and renal failure (OR 1.35 P = <.0001) were independent predictors of readmission within 30 days.
Nationally representative readmission metrics can be used to benchmark hospitals’ performance, and a temporal trend of 4.4 % may be used to evaluate the e"ectiveness of readmission reduction strategies.  
Authors/Disclosures
Mohammad Rauf A. Chaudhry, MD
PRESENTER 		Dr. Chaudhry has nothing to disclose.
Ibrahim Laleka No disclosure on file
Hussan Gill Mr. Gill has nothing to disclose.
Saqib A. Chaudhry, MD Dr. Chaudhry has nothing to disclose.
No disclosure on file
No disclosure on file
Haseeb A. Rahman, MD (Baylor University Medical Center Institute) Dr. Rahman has nothing to disclose.
Pouya Tahsili-Fahadan, MD (Johns Hopkins Medical Institutes) Dr. Tahsili-Fahadan has received publishing royalties from a publication relating to health care.
No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology) Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.