Early Risk of Readmission Following Hospitalization for Reversible Cerebral Vasoconstriction Syndrome.

Objective: For evaluation of 90-day readmissions following an inpatient admission for reversible cerebral vasoconstriction syndrome (RCVS), hospitalizations due to RCVS were identified from the Nationwide Readmissions Database 2016-2017. Methods: The primary outcome of interest was non-elective readmission within 90 days of index hospitalization discharge. Survival analysis was performed, and multivariable Cox proportional hazards regression was used to determine the factors associated with readmission. Results: Among the 1,157 hospitalizations due to RCVS during the study period (mean±SD age: 48.6±16.1 years; women 76.4%), 164 (14.2%) patients had non-elective readmission within 90 days of discharge. The most common reasons for readmissions included acute cerebrovascular events (18.9%), continued or recurrent symptoms of RCVS (13.4%), infections (11.6%), and headache (9.8%). Diabetes, history of tobacco use, opioid use, and longer length of index hospitalization were independent predictors of 90-day readmission. For readmissions, the mean (SD) length of stay was 5.2 (6.1) days, and the mean (SD) cost per hospitalization was $14,214 ($15,140). There was no in-hospital mortality; however, 37.2% of patients were not discharged to home. Conclusion: Nearly 14% of patients with RCVS get readmitted within 90 days of discharge, and a significant proportion of these readmissions are due to the ongoing/recurrent symptoms or neurologic sequelae of RCVS. Given that these patients are at a risk of early recurrence/worsening of their symptoms, an early post-discharge follow-up plan may need to be integrated into their care.