Abstract WP446: Predictors of 30-Day Readmissions and in Hospital Mortality Following Intracerebral Hemorrhage (ich)-A 5-Year National Estimate

Abstract

Background: Intracerebral hemorrhage (ICH) is one of the more devastating types of stroke with worse short-term outcomes. There is a paucity of data regarding preventable causes of readmission and predictors of short-term outcomes post-ICH. Method: Nationwide Readmissions Database (NRD) from 2010-14 was utilized to identify ICH using appropriate ICD-9CM codes in the primary diagnostic field. Admissions within 30 days of discharge were considered as early readmission and predictors to assess an association between baseline characteristics and 30-day readmission and mortality were analyzed using multivariable logistic regression model. Result: We identified 276,401 patients with ICH in our study, of which 37,689 (10%) were readmitted within 30 days (Mean age 68.3 years; 52.8% male). Hypertension was the major comorbidity in the readmitted population (77.7%) followed by diabetes (33.5%), anemia (21.9%), and atrial fibrillation (20.7%). Comorbid conditions like diabetes, heart failure, atrial fibrillation (AF), anemia, coagulopathy, chronic renal failure (CRF), valvular heart disease (VHD), liver disease, in-hospital septicemia, urinary tract infection, Pneumonia, deep venous thrombosis and discharge to another facility were significant predictors of 30-day readmission. Advancing age, heart failure, AF, CRF, liver disease, coagulopathy, hospitalization on weekends, in-hospital complications such as acute renal failure, sepsis, pneumonia was predictive of increased 30-day mortality. Non-emergent index admissions in large bed size, teaching hospital and private insurance were associated with decreased mortality. Conclusion: In conclusion, ICH was associated with a 10% readmission rate during our study period. Identification of high-risk population based on certain preexisting comorbidities and in-hospital complications, better follow up and transition of care can have improved outcomes in these patients and reduce healthcare burden.