title: Nationwide Estimates of 30-Day Readmission in Patients With Ischemic Stroke.
abstract: Readmission within 30 days of hospital discharge for ischemic stroke is an important quality of care metric. We aimed to provide nationwide estimates of 30-day readmission in the United States, describe important reasons for readmission, and sought to explore factors associated with 30-day readmission, particularly the association with recanalization therapy.
  
  
  
  We conducted a weighted analysis of the 2013 Nationwide Readmission Database to represent all US hospitalizations. Adult patients with acute ischemic stroke including those who received intravenous tissue-type plasminogen activator and intra-arterial therapy were identified usingInternational Classification of Diseases-Ninth Revision codes. Readmissions were defined as any readmission during the 30-day post-index hospitalization discharge period for the eligible patient population. Proportions and 95% confidence intervals for overall 30-day readmissions and for unplanned and potentially preventable readmissions are reported. Survey design logistic regression models were fit for determining crude and adjusted odds ratios and 95% confidence interval for association between recanalization therapy and 30-day readmission.
  
  
  
  Of the 319 317 patients with acute ischemic stroke, 12.1% (95% confidence interval, 11.9-12.3) were readmitted. Of these, 89.6% were unplanned and 12.9% were potentially preventable. More than 20% of all readmissions were attributable to acute cerebrovascular disease. Readmitted patients were older and had a higher comorbidity burden. After controlling for age, sex, insurance status, and comorbidities, patients who underwent recanalization therapy had significantly lower odds of 30-day readmission (odds ratio, 0.82; 95% confidence interval, 0.77-0.89).
  
  
  
  Up to 12% of patients with ischemic stroke get readmitted within 30 days post-discharge period, and recanalization therapy is associated with 11% to 23% lower odds of 30-day readmission.
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.). Farhaan.Vahidy@uth.tmc.edu.
authors.forename: Farhaan S
authors.initials: FS
authors.lastname: Vahidy
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.).
authors.forename: John P
authors.initials: JP
authors.lastname: Donnelly
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.).
authors.forename: Louise D
authors.initials: LD
authors.lastname: McCullough
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.).
authors.forename: Jon E
authors.initials: JE
authors.lastname: Tyson
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.).
authors.forename: Charles C
authors.initials: CC
authors.lastname: Miller
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.).
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Boehme
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.).
authors.forename: Sean I
authors.initials: SI
authors.lastname: Savitz
authors.affiliation: From the Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston (F.S.V., L.D.M., S.I.S.); Department of Emergency Medicine (J.P.D.) and Department of Neurology (K.C.A.), University of Alabama School of Medicine, Birmingham; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, University of Texas Health Science Center, Houston (J.E.T., C.C.M.); and Department of Neurology, Columbia University, New York, NY (A.K.B.).
authors.forename: Karen C
authors.initials: KC
authors.lastname: Albright
mesh_terms: D002545:Brain Ischemia / Q000188:drug therapy / Q000628:therapy*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D010359:Patient Readmission / Q000706:statistics & numerical data*; D020521:Stroke / Q000188:drug therapy / Q000628:therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014481:United States; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: brain ischemia; cerebrovascular disorders; patient discharge; patient readmission; stroke