Abstract T P293: Determinants of Early Withdrawal of Care in Patients Who Die During Index Hospitalization for Acute Ischemic Stroke

Introduction: CMS recently announced plans to report risk-standardized stroke mortality. Decisions to withdraw medical care after acute ischemic stroke are based on numerous factors, not just the severity of the incident stroke. Withdrawal of care decisions have the potential to confound these adjusted mortality rates. We investigated factors associated with early withdrawal of care in patients hospitalized with AIS. Methods: We used our institutional GWTG database (1474 consecutive stroke inpatients from 12/2009 - 12/2012) to identify 176 consecutive in-hospital mortalities; of these, 100 patients were transitioned to comfort care during hospitalization. Chart review was performed on these 100 patients to identify factors associated with early (< 5 days) withdrawal of care. Results: Seventy-eight patients (78%) had early withdrawal of care. Table 1 shows the comparison of patients with early (<5 days) versus late (≥ 5 days) withdrawal of care decisions. As shown, Early-CMO patients were younger, and less...