Abstract WP461: Etiology and Trends of 30-day Readmissions Following Intracerebral Hemorrhage (ICH)-review of 5 Years Nationwide Readmission Database

Abstract

Background: Intracerebral hemorrhage (ICH) is the second most cause of stroke following ischemic stroke in United states and associated with poor short-term outcomes. It is important to understand the etiology of readmission and outcomes associated with ICH population; however, data is scarce. Methods: Nationwide Readmissions Database (NRD) from 2010-14 was utilized to identify ICH using appropriate ICD-9CM codes in primary diagnostic field. Admissions within 30 days of discharge from index admission were considered as early readmission and P values for trends were generated by Cochrane-Armitage test for categorical variables and simple linear regression for continuous variables. Results: We identified 276,401 patients who survived to discharge after ICH during 2010-14, 27,689 (10%) were readmitted within 30 days (Mean age 68.3 years; 52.8% male). We observed an increase in ICH hospitalization (From 55,405 in 2010 to 56,685 in 2014) with significant decline in 30-day readmissions (10.4 % in 2010 to 9.7% in 2014, ptrend<0.0001). A large proportion of patients (58%) had significant baseline burden of comorbidities with a CCI score ≥ 3. Compared to non-readmitted patients they were associated with longer length of stay (14 vs 10 days) and higher mean cost (33,561 vs 24,360 dollars). Common etiologies of readmissions were neurological (29.3%), infectious (13.6%), kidney or urinary (10.1%), cardiac (9.3%) and pulmonary (8.9%). Among neurological causes ICH (11.8%), Ischemic stroke (5.2%), Epilepsy (2.4%) and late effects of ICH (2.4%) were common etiologies. (Figure) Conclusion: One in 10 patients were readmitted within 30 days after discharge from index hospitalization for ICH. Neurological conditions remain the most common causes for readmission followed by infectious causes. Identification of these high-risk patients and better transition of care will further reduce the readmission rate and morbidity.