Abstract 262: National Trends of 90‐day Readmission Rates and Etiologies among Diabetics following Transient Ischemic Attack

Abstract

Introduction Transient Ischemic Attack (TIA) is a common neurologic condition characterized by temporary, focal cerebral ischemia that results in reversible neurological deficits without tissue infarction. Type 2 Diabetes Mellitus (T2DM) is a rapidly growing global health problem with increasing prevalence. Currently, data are lacking regarding the trends of 90‐day readmission rates and etiologies among diabetic patients with TIA. Methods We used the Nationwide Readmission Database (NRD) to identify patients with a primary diagnosis of TIA (ICD‐10 code: G45.9) from 2016‐2019 and secondary diagnosis of T2DM. The difference in days between the index admission and the readmission was used to identify patients who were readmitted within 90 days. The primary diagnosis of the readmission was used to identify the etiology of readmission. Data was weighted to allow for representative nationwide estimates. Results We identified 426,549 patients who were admitted with a primary diagnosis of TIA between 2016 and 2019. Of those patients, 35.43% (n=273,993) were diabetic and 64.57% (n=151,112) were non‐diabetic. Diabetics were more likely to be younger (70.43 vs 70.71 years, p<0.001) and male (46.62% vs 42.89%, p<0.001) compared to non‐diabetics. All‐cause 90‐day readmission was higher among diabetics compared to non‐diabetics (15.22% vs 12.03%, p<0.001). Nearly half of 90‐day readmissions occurred within 30 days. There was no significant difference in the rate of 90‐day readmission between 2016 and 2019 (13.19% in 2016 and 12.95% in 2019). Among diabetics, readmitted patients were more likely to be older (71.87 vs 70.18 years, p<0.001) and male (47.96% vs 46.38%, p<0.001). Readmitted diabetics had a higher prevalence of valvular disease (10.12% vs 7.94%), chronic renal failure (33.40% vs 23.98%), coronary artery disease (40.20% vs 32.86%), heart failure (23.88% vs 16.07%), atrial fibrillation (24.02% vs 18.88%), dementia (13.87% vs 11.13%), cancer (4.18% vs 2.44%), and prior VTE (5.24% vs 4.44%) (p<0.001 for all). The most common etiologies of 90‐day readmission among diabetics were cardiovascular (28.98%), neurological (12.92%), and infectious (7.72%). Conclusion Diabetics had higher 90‐day readmission following TIA than non‐diabetics. Cardiovascular conditions were the most common cause of readmission followed by neurological and infectious causes. Further studies are needed to improve risk stratification for diabetic patients following TIA and prevent all‐cause readmission.