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Abstract Details

Hospital readmission rates among acute ischemic stroke survivors with severe mental illness
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
173
To determine the association between co-occurring severe mental illness (SMI) and the risk of all-cause 30-day hospital readmission in a national sample of acute ischemic stroke (AIS) survivors.
Every year, approximately 800,000 Americans suffer an AIS. Persons with SMI, which affects 11.2 million people, have a disproportionately higher risk of stroke and hospital readmissions. The extent to which co-occurring SMI increases the risk of readmission among AIS survivors is unknown.

The 2017 Nationwide Readmissions Database (NRD) was used to retrospectively identify all adults (18+) that were hospitalized for AIS in the United States between February 1, 2017 and November 30, 2017. International Classification of Disease, Tenth Revision (ICD-10) diagnostic codes were used to identify AIS survivors with and without SMI. Multivariable logistic regression model was used to estimate odds of all-cause 30-day readmission, controlling for patient- and hospital-level covariates. A sensitivity analysis was completed to examine the risk of all-cause 30-day readmission in patients 65 years and older.

Of the 1,035,375 AIS hospitalizations, 108,671 experienced a 30-day readmission (10.5%). Persons with a history of AIS and SMI (n=36,580; 3.5%) accounted for 5,176 readmissions (4.7%). AIS survivors with SMI were significantly younger than AIS survivors without SMI (61.7 (SD 13.2) vs. 71.8 years (13.8), p <0.001), and were more likely to have 4 or more Elixhauser comorbidities compared to AIS survivors without SMI (54.6% vs 52.6%, p < 0.001). In our adjusted analysis, AIS survivors with SMI experienced higher odds of all-cause 30-day readmissions, both in the full sample (odds ratio [OR]: 1.24, 95% CI: 1.20, 1.27, p<0.001) and among those >65 years of age (OR: 1.21, 95% CI: 1.15, 1.27, p<0.001).
Recognizing that ischemic stroke survivors with SMI have significantly higher odds of 30-day readmission, quality improvement efforts should be considered to support this high-risk population.
Authors/Disclosures
Yasir Salih, DO
PRESENTER 		Dr. Salih has nothing to disclose.
Hena Waseem, MD (Stanford University Hospital) Dr. Waseem has nothing to disclose.
No disclosure on file
No disclosure on file
Nathaniel M. Robbins, MD (MGB) Dr. Robbins has received personal compensation in the range of $0-$499 for serving as a Consultant for Red Nucleus. Dr. Robbins has received personal compensation in the range of $0-$499 for serving as a Consultant for TDG Health. Dr. Robbins has received personal compensation in the range of $0-$499 for serving as a Consultant for Jupiter Life Science Consulting. Dr. Robbins has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Vaccine Injury Compensation Program. The institution of Dr. Robbins has received research support from Diamond Endowment Fund. The institution of Dr. Robbins has received research support from Reeves Endowment Fund. The institution of Dr. Robbins has received research support from Institute for Ethnomedicine. The institution of Dr. Robbins has received research support from Theravance. The institution of Dr. Robbins has received research support from Dysautonomia International. The institution of Dr. Robbins has received research support from National Institute of Health. The institution of Dr. Robbins has received research support from Vertex pharmaceutical. Dr. Robbins has received personal compensation in the range of $50,000-$99,999 for serving as a Locums neurohospitalist with Hayes Locums. Dr. Robbins has received personal compensation in the range of $500-$4,999 for serving as a Speaker with The Dysautonomia Project.