LACE+ is marginally predictive of 30-day readmission after stroke (P11-5.027)

Abstract

<h3>Objective:</h3> We aimed to investigate predictors of 30-day same hospital readmission after stroke and incorporate these factors in a predictive model. <h3>Background:</h3> Hospital readmissions after stroke is costly and negatively impact outcomes. <h3>Design/Methods:</h3> Patients discharged with a primary diagnosis of ischemic stroke and intracerebral hemorrhage between 1/1/2018 and 12/31/2020 were included. Transient Ischemic Attack (TIA) patients were excluded from the analysis. LACE+ index, age, smoking status, primary care physician (PCP) status, type of stroke, admission National Institute of Health Stroke Scale (aNIHSS), thrombolysis and thrombectomy use were compared between patients with or without unplanned 30-day readmission. Logistic regression was used to generate readmission predictive models. <h3>Results:</h3> A total of 3319 patients were identified. Of these 196 TIA patients were excluded from the analysis. Mean age was 67.8 ± 15.27 years. Readmission rate was 9.5% for the whole cohort (ischemic stroke 7.7% and hemorrhagic stroke 14%). Readmitted patients had a high LACE+ score (≥ 60; 73%), low aNIHSS (0–5; 50%), were smokers (61%) and did not have an established PCP (94%) at the time of index admission. Readmitted patients were also less likely to have received thrombolysis (88%) or thrombectomy (80%) during index admission. Logistic regression incorporating LACE+, aNIHSS and stroke type (hemorrhage) were mildly predictive of 30-day unplanned readmission (Model A; c-stat 0.60). Addition of smoking status, alcohol status, primary care physician status, thrombolysis and thrombectomy use slightly improved the predictive ability of the model (Model B; c-stat 0.62). <h3>Conclusions:</h3> LACE+ is marginally predictive of 30-day unplanned readmission after stroke. Better scores incorporating socioeconomic, neurological and cerebrovascular variables are needed to predict readmission after stroke. <b>Disclosure:</b> The institution of Dr. Khan has received research support from NINDS. The institution of Dr. Khan has received research support from Genentech. The institution of Dr. Khan has received research support from Spectrum Health-MSU alliance. Dr. Khan has received research support from NIH. Mr. Hildreth has nothing to disclose. Dr. Haggerty has nothing to disclose. Dr. Knight has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Tsai has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Mrs. Scott has nothing to disclose. Tricia Tubergen has received personal compensation in the range of $0-$499 for serving as a Consultant for Medtronic. Mrs. Evans has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Wees has nothing to disclose. Dr. Ahrar has nothing to disclose. Dr. Min has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott . Dr. Min has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic . Dr. DeJesus Brazitis has nothing to disclose. Laurel Packard has nothing to disclose.