Abstract TMP40: The Impact of Social Determinants of Health on Stroke Readmissions and Recovery

Abstract

Introduction: The consequences of increased morbidity and increased socioeconomic strain, for stroke survivors and their families, is well documented in stroke literature worldwide. Variables that determine readmission rates of stroke survivors may be complicated by the intersection of social determinants of health (SDOH). SDOH include race/ethnicity, insecurities, living conditions, social isolation, health literacy, income and education. This single center, prospective, observational study explores SDOH that lead to higher risk of readmission (within 30-days to 30-90 days) after discharge from the hospital once diagnosed with stroke or transient ischemic attack (TIA). Methods: A questionnaire was distributed to 100 patients admitted with acute stroke or TIA per the study inclusion criteria. Additional variables of interest collected included race, ethnicity, income, insurance status, treatment, baseline and discharge National Institutes of Health Stroke Scale score and modified Rankin scale (mRS) score, comorbidities, zip code and discharge disposition. Results: Univariate analysis found prior stroke/TIA and baseline mRS score of 0-2 to be statistically significant at predicting readmission within 30-days, p=0.07 and p=0.01, respectively. Multivariate analysis showed patients who find it difficult to eat healthy and participate in activities to improve their health, have history of prior TIA/stroke, coronary artery disease, diabetes and baseline mRS score were highly predictive for readmission. Discussion: SDOH are thought to contribute to readmission rates for patients who experienced stroke or TIA. In conclusion, our preliminary study found that patients who admitted to difficulties maintaining a healthy lifestyle had a correlation with both 30-day and 30-90 day readmission. Further studies are needed to identify the SDOH variables that most accurately predict readmission after stroke/TIA. This will further the mandate for increased precision medicine, tailoring targeted interventions to improve the quality of life for stroke survivors.