Abstract 56: Predictors Of Post Stroke Discharge Follows-ups In The Stroke Clinic And Role Of A Stroke Navigator To Improve Follow-ups

Abstract

Objective: We aimed to evaluate which factors contributed to acute ischemic stroke (AIS) following up in stroke clinic post hospitalization. Methods: Single center retrospective analysis of AIS patients from January 2016 to April 2021. Patients were excluded if: died during index hospitalization, discharged to hospice or had incomplete data. We evaluated our primary outcome: factors contributing to patients attending post-discharge appointments and secondary outcome: factors contributing to patients scheduling post-discharge appointments utilizing binomial stepwise logistic regression models. Subgroup analysis compared latency to be seen in follow-up clinic between patients who had an appointment scheduled at discharge compared to those who did not using a Mann-Whitney test. Results: Out of 7960 AIS patients, 2734 were included in this study, 2130 (77.9%) of those patients scheduled an appointment post-discharge, whereas 1649 (60.3%) attended an appointment post-discharge. Patients were more likely to attend a follow-up appointment if scheduled while hospitalized, OR=3.48 [95%CI, 2.94-4.14], p<0.001 and less likely if: older OR=0.98 [95%CI 0.97-0.98], p<0.001; admitted for a longer duration, OR=0.98 [95%CI, 0.96-1.00], p=0.05; lived farther away OR=0.99 [95%CI, 0.96-0.99], p<0.001 or had higher modified Rankin Scale (mRS) at discharge OR=0.73 [95%CI, 0.69-0.79], p<0.001. Patients were more likely to schedule a follow-up appointment after initiation of the AIS navigator program, OR=8.52 [95%CI, 6.59-10.57], p<0.001.Patients with follow-up appointments scheduled during their initial hospitalization were seen in clinic sooner; 27 days (IQR 19-36) versus 37 days (IQR 22-61), p<0.001. Conclusion: Patients with AIS were more likely to schedule an appointment after initiation of a nurse navigator program. Patients were also more likely to attend post-discharge stroke clinics if their appointments were scheduled during index hospitalization.