Abstract TMP21: Hospital Characteristics Influencing Discharge Disposition Following Acute Stroke: Findings From the Get With the Guidelines-Stroke Registry

Abstract

Background: Medical comorbidities and stroke risk factors explain only a proportion of stroke incidence and outcomes in different populations. Our analysis aimed to determine if hospital characteristics are associated with discharge home following acute ischemic stroke (AIS) hospitalization. Methods: The analyses included AIS patients hospitalized from January 1, 2015 to December 31, 2019 who were ambulating at baseline. The primary outcome measure was discharge to home. Hospital-level characteristics including time and day of arrival, location of stroke onset, transport mode, hospital bed size and stroke center certification status. The relative odds of outcome were assessed using a multivariable logistic regression. Results: Of 1,171,519 observations included in our analysis, median age was 71 years, 49% were female and 78% were of white race. As shown in the Table, factors associated with lower odds of home discharge included night-time arrival, stroke onset in a chronic care facility, arrival by ambulance, geographic location, and no stroke center certification; these factors were independent of social determinants of health such as education, income, employment status, poverty, and frequency of foreign-born residents at patients’ residence county. There was a trend towards improved outcomes over the study period. Conclusion: Hospital level characteristics influence likelihood of home discharge after AIS, independent of social determinants of health.