Annual incidences and predictors of 30-day readmissions following spontaneous intracerebral hemorrhage from 2010 to 2014 in the United States: A retrospective Nationwide analysis

Hoffman, Haydn; Furst, Taylor; Jalal, Muhammad S.; Chin, Lawrence S.

doi:10.1016/j.heliyon.2019.e03109

Cited by 3 publications

(4 citation statements)

References 37 publications

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“…Data on readmission costs of ICH were identified in 11 studies (Table 6 and Appendix Supplemental Table 8 ) [ 29 , 35 , 36 , 40 , 45 – 48 , 55 , 56 , 62 , 68 ], although one of these studies provided readmission costs only for both intracerebral and subarachnoid hemorrhage (SAH) [ 47 ]. In a 12-month follow-up period, the all-cause intracerebral hemorrhage readmission costs per patient were reported by Lee et al [ 47 ] in Taiwan ($4102), Meretoja et al [ 48 ] in Finland ($5009), and Goere et al [ 46 ] in Canada ($5905).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 44 reviewed studies, six focused on readmission costs as their primary study objective, while the remaining studies provided a global assessment of stroke or post-stroke care costs [ 28 , 37 , 47 , 56 , 67 , 68 ]. Stein et al [ 67 ] was the only one that identified readmission after IS in another hospital as a predictor of increased readmission charges.…”

Section: Resultsmentioning

confidence: 99%

“…These findings may result from a relative scarcity of studies examining readmission costs specifically related to SAH. Additionally, this might reflect a survivorship bias, as IS is associated with higher survival rates following an index stroke, and patients who died during the index admission are not eligible for readmission analysis [ 48 , 66 , 68 ].…”

Section: Discussionmentioning

confidence: 99%

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Rapid systematic review of readmissions costs after stroke

Abreu,

Correia,

Azevedo

et al. 2024

Cost Eff Resour Alloc

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Background Stroke readmissions are considered a marker of health quality and may pose a burden to healthcare systems. However, information on the costs of post-stroke readmissions has not been systematically reviewed. Objectives To systematically review information about the costs of hospital readmissions of patients whose primary diagnosis in the index admission was a stroke. Methods A rapid systematic review was performed on studies reporting post-stroke readmission costs in EMBASE, MEDLINE, and Web of Science up to June 2021. Relevant data were extracted and presented by readmission and stroke type. The original study’s currency values were converted to 2021 US dollars based on the purchasing power parity for gross domestic product. The reporting quality of each of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results Forty-four studies were identified. Considerable variability in readmission costs was observed among countries, readmissions, stroke types, and durations of the follow-up period. The UK and the USA were the countries reporting the highest readmission costs. In the first year of follow-up, stroke readmission costs accounted for 2.1–23.4%, of direct costs and 3.3–21% of total costs. Among the included studies, only one identified predictors of readmission costs. Conclusion Our review showed great variability in readmission costs, mainly due to differences in study design, countries and health services, follow-up duration, and reported readmission data. The results of this study can be used to inform policymakers and healthcare providers about the burden of stroke readmissions. Future studies should not solely focus on improving data standardization but should also prioritize the identification of stroke readmission cost predictors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Rapid systematic review of readmissions costs after stroke

Abreu,

Correia,

Azevedo

et al. 2024

Cost Eff Resour Alloc

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“…Some studies have analyzed unstratified ICH populations to determine the specific risk factors and readmission rates and reasons. Thirty-day readmission rates in the US national studies were reported as 12-14% and top readmission reasons included cerebrovascular and infectious etiologies [9,10]. Given the reported differences in ICH etiologies for different age groups and high costs associated with unplanned readmissions, it is important to delineate factors that affect ICH etiology and outcomes.…”

Section: Introductionmentioning

confidence: 99%

Index Admission Characteristics and All-Cause Readmissions Analysis in Younger and Older Adults with Intracerebral Hemorrhage

et al. 2020

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Introduction: Intracerebral hemorrhage (ICH) comprises 15-20% of all strokes with debilitating consequences. Data regarding characteristics and outcomes of primary ICH in the young are lacking, given its rarity, making comparisons between younger and older cohorts difficult to perform. Nationally representative administrative databases enable analysis of such rare events. Objective: To determine the baseline characteristics, all-cause readmission rates, and reasons for primary ICH in younger and older adults using a nationally representative database. Methods: A retrospective cohort analysis was performed using the Nationwide Readmissions Database 2013. Validated ICD-9-CM codes identified index ICH admissions, comorbidities, demographics, behavioral risk factors, procedures, and Elixhauser and Charlson Comorbidity indices. We compared "younger" (age ≤ 45 years) and "older" (age > 45) index ICH admissions by weighted 30-day all-cause readmission rates, primary diagnosis code for 30-day readmissions, most common comorbidities during the index hospitalization, and Kaplan-Meier cumulative risk of readmission up to 1 year. Results: Older admissions had higher comorbidity scores and mortality, but both groups had similar total comorbidities. Younger admissions exhibited longer length of stay with more procedures performed. Vascular anomalies (aneurysm 7.2 vs. 4.6% and arteriovenous malformation 5.9 vs. 0.8%) and behavioral risk factors (smoking 26.5 vs. 23.0%, alcohol abuse 6.7 vs. 4.6%, and substance use 13.5 vs. 2.9%) were more prevalent in younger admissions, while older patients had more cardiovascular comorbidities. All-cause 30-day readmission rates (13.1 vs. 13.0%) and 1-year cumulative risk of readmission (log-rank p value 0.7209) were similar. Readmissions in the younger cohort were primarily for neurological conditions, and those in the older cohort were for systemic conditions. Conclusions: Adults <45 years with ICH had similar total comorbidities as older adults but more procedures, longer hospital stay, and more behavioral risk factors. Readmission rates were similar though reasons differed; younger patients were more for neurological reasons than for other systemic causes.

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