Aayushi Garg1, Matthew Starr2, Marcelo Rocha2, Santiago Ortega-Gutierrez3. 1. Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA. 2. Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA. 3. Department of Neurology, Neurosurgery, and Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA santy-ortega@uiowa.edu.
Abstract
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.
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.
Authors: Seby John; Aneesh B Singhal; Leonard Calabrese; Ken Uchino; Tariq Hammad; Stewart Tepper; Mark Stillman; Brittany Mills; Tijy Thankachan; Rula A Hajj-Ali Journal: Cephalalgia Date: 2015-06-18 Impact factor: 6.292
Authors: Aneesh B Singhal; Mehmet A Topcuoglu; Joshua W Fok; Oguzhan Kursun; Raul G Nogueira; Matthew P Frosch; Verne S Caviness Journal: Ann Neurol Date: 2016-04-28 Impact factor: 10.422