BACKGROUND AND PURPOSE: Ischemic stroke patients treated at Joint Commission Primary Stroke Center (JC-PSC)-certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC-certified versus noncertified hospitals. METHODS: The study included all fee-for-service Medicare beneficiaries aged 65 years or older with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC-certified hospital on 30-day mortality and readmission. RESULTS: There were 2305 SAH and 8708 ICH discharges from JC-PSC-certified hospitals and 3892 SAH and 22 564 ICH discharges from noncertified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% versus 33.2%, P<0.0001; ICH: 27.9% versus 29.6%, P=0.003) and 30-day mortality (SAH: 35.1% versus 44.0%, P<0.0001; ICH: 39.8% versus 42.4%, P<0.0001) were lower in JC-PSC hospitals, but 30-day readmission rates were similar (SAH: 17.0% versus 17.0%, P=0.97; ICH: 16.0% versus 15.5%, P=0.29). Risk-adjusted 30-day mortality was 34% lower (odds ratio, 0.66; 95% confidence interval, 0.58-0.76) after SAH and 14% lower (odds ratio, 0.86; 95% confidence interval, 0.80-0.92) after ICH for patients discharged from JC-PSC-certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. CONCLUSIONS: Patients treated at JC-PSC-certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with noncertified hospitals.
BACKGROUND AND PURPOSE:Ischemic strokepatients treated at Joint Commission Primary Stroke Center (JC-PSC)-certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC-certified versus noncertified hospitals. METHODS: The study included all fee-for-service Medicare beneficiaries aged 65 years or older with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC-certified hospital on 30-day mortality and readmission. RESULTS: There were 2305 SAH and 8708 ICH discharges from JC-PSC-certified hospitals and 3892 SAH and 22 564 ICH discharges from noncertified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% versus 33.2%, P<0.0001; ICH: 27.9% versus 29.6%, P=0.003) and 30-day mortality (SAH: 35.1% versus 44.0%, P<0.0001; ICH: 39.8% versus 42.4%, P<0.0001) were lower in JC-PSC hospitals, but 30-day readmission rates were similar (SAH: 17.0% versus 17.0%, P=0.97; ICH: 16.0% versus 15.5%, P=0.29). Risk-adjusted 30-day mortality was 34% lower (odds ratio, 0.66; 95% confidence interval, 0.58-0.76) after SAH and 14% lower (odds ratio, 0.86; 95% confidence interval, 0.80-0.92) after ICH for patients discharged from JC-PSC-certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. CONCLUSIONS:Patients treated at JC-PSC-certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with noncertified hospitals.
Authors: T I Gropen; P J Gagliano; C A Blake; R L Sacco; T Kwiatkowski; N J Richmond; D Leifer; R Libman; S Azhar; M B Daley Journal: Neurology Date: 2006-07-11 Impact factor: 9.910
Authors: Susan Unipan Lattimore; Julio Chalela; Lisa Davis; Thomas DeGraba; Mustapha Ezzeddine; Joseph Haymore; Paul Nyquist; Alison E Baird; John Hallenbeck; Steven Warach Journal: Stroke Date: 2003-05-15 Impact factor: 7.914
Authors: Gustavo Saposnik; Moira K Kapral; Shelagh B Coutts; Jiming Fang; Andrew M Demchuk; Michael D Hill Journal: Stroke Date: 2009-07-30 Impact factor: 7.914
Authors: Gregory C Pope; John Kautter; Randall P Ellis; Arlene S Ash; John Z Ayanian; Lisa I Lezzoni; Melvin J Ingber; Jesse M Levy; John Robst Journal: Health Care Financ Rev Date: 2004
Authors: Sidney T Le; S Andrew Josephson; Hans A Puttgen; Lorrie Gibson; Elan L Guterman; Heather M Leicester; Carla L Graf; John C Probasco Journal: Neurohospitalist Date: 2016-10-22
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: John W Liang; Laura Cifrese; Lili Velickovic Ostojic; Syed O Shah; Mandip S Dhamoon Journal: Neurocrit Care Date: 2018-12 Impact factor: 3.210
Authors: Austin M Tang; Joshua Bakhsheshian; Li Ding; Casey A Jarvis; Edith Yuan; Ben Strickland; Steven L Giannotta; Arun Amar; Frank J Attenello; William J Mack Journal: World Neurosurg Date: 2019-07-05 Impact factor: 2.104
Authors: Yun Wang; Judith H Lichtman; Kumar Dharmarajan; Frederick A Masoudi; Joseph S Ross; John A Dodson; Jersey Chen; John A Spertus; Sarwat I Chaudhry; Brahmajee K Nallamothu; Harlan M Krumholz Journal: Am Heart J Date: 2014-06-14 Impact factor: 4.749
Authors: Jacob K Greenberg; Ridhima Guniganti; Eric J Arias; Kshitij Desai; Chad W Washington; Yan Yan; Hua Weng; Chengjie Xiong; Emily Fondahn; DeWitte T Cross; Christopher J Moran; Keith M Rich; Michael R Chicoine; Rajat Dhar; Ralph G Dacey; Colin P Derdeyn; Gregory J Zipfel Journal: J Neurosurg Date: 2016-08-05 Impact factor: 5.115
Authors: Eric M Liotta; Mandeep Singh; Adam R Kosteva; Jennifer L Beaumont; James C Guth; Rebecca M Bauer; Shyam Prabhakaran; Neil F Rosenberg; Matthew B Maas; Andrew M Naidech Journal: Crit Care Med Date: 2013-12 Impact factor: 7.598