Abstract TP76: Lost To Follow Up As A Missed Opportunity In ICH Survivors

Abstract

Introduction: Improving rates of in-hospital survival in intracerebral hemorrhage (ICH) have led to opportunities to implement secondary prevention and recovery measures. Lost to follow up is not well characterized in this disabled population. The objective of this analysis was to describe the frequency of lost to follow up for ICH survivors from an urban comprehensive stroke center and thrombectomy capable center. Methods: We included n=409 ICH patients from December 2016 to February 2022. With chart review, we collected data regarding the admission, discharge and follow-up. Our primary outcome measure was a modified Rankin scale (mRS) score of 0 - 3 during their last recorded follow-up. Pearson correlation analyses were performed using R statistical software to determine if there was a significant correlation between the number of follow-ups a patient received and their final recorded mRS score. Results: Of 409 ICH patients, 80 died within the first month of their index hospitalization or had incomplete records that prevented further analysis. Of the 329 patients, 181 were minorities (83 blacks, 49 asian and 49 hispanics) and 90 were white. About 85% (279/329) had insurance. Only 162 received 3 or more follow-ups post-index hospitalization, with 47 patients never receiving any follow-ups after their initial discharge. Of those that received follow up, the average number of follow ups was 2.57, with an average time of 366.17 days between discharge and the last recorded follow-up. Among the 282 patients that received at least one follow-up, there was a significant negative correlation between the number of follow-ups a patient received and their final recorded mRS score (p = 0.0000339, r = -0.246). There was no significant differences related to age, race or insurance status for those who followed up versus those who were lost to follow up. Conclusions: In a large urban health system, 14% ICH survivors were lost to follow-up. ICH survivors with good functional outcomes received more follow-up. There is a need to improve systems of care to prevent ICH patients from getting lost to follow-up and improving long term outcomes.