Assessment of hospital readmissions in stroke patient population from the Stroke Center at the University of Kentucky: as a quality measure (P5.150)

Background: Hospital readmission has become a major hospital quality metric. We sought to quantify hospitalization rates and etiologies for stroke readmissions. Methods and Results: We searched our stroke center patient admission database for dates between July 2012 and June 2014. We reviewed patients with readmissions within 30 days of the previous hospital stay. We identified 123 patients (N=123). Electronic medical records were analyzed, and cranial images were reviewed as needed. Days from discharge represents the number of days calculated from date of initial discharge to date of readmission. Patients were subdivided based on initial presentation into those admissions with neurologic, non-neurologic, and elective etiologies. Elective admissions were planned admissions for vascular procedures following an initial admission and were separately analyzed. 52[percnt] of patients were admitted for non-neurologic etiologies. Such etiologies included (in order of frequency): infections N=19(15[percnt]), organ failure N=15(12[percnt]), and bleeding complications N=8 (6[percnt]). Of those infection, urinary tract infections were the most common cause N=9 (53[percnt]), followed by pneumonia N=4 (21[percnt]). Patients manifested with sepsis in more than one third of patients with infection; N=7 (37[percnt]). Presentations with neurologic complications were common; N=48 (39[percnt]). Of these, 10 patients (21[percnt]) manifested with worsening symptoms related to stroke as diagnosed on prior admission, while 19 of these patients (40[percnt]) experienced another acute ischemic event. Vascular distribution for the new ischemic strokes was variable. Seizures were identified in two subjects. Patients presented at variable days following hospital discharge, however, they most frequently presented four days after, with 30 days being the latest. Conclusions: Our study determined etiologies for hospital readmission after initial stroke hospitalization. Urinary tract infections were found to be the most common cause for stroke readmissions. Further analysis may help to identify risks for readmission and potentially reduce readmission rates. Disclosure: Dr. Al Sawaf has nothing to disclose. Dr. Lee has nothing to disclose.