Early versus late readmission of subarachnoid haemorrhage patients into neurocritical care

Low, Jacob Chen Ming; Welbourne, Jessie; McMillan, Helen; Whitfield, Peter

doi:10.1080/02688697.2016.1199782

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…In this study, we focused on evaluating the readmission rate of patients during their first hospital stay and determining the causes of ICU readmission. DCI was the most common cause, accounting for 55.6% ( n =15) of the patients, a result similar to that in another study [ 9 ]. This finding was not surprising, because 79.7% ( n =275) of our study population had MFS Grades III or IV.…”

Section: Discussionsupporting

confidence: 88%

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Readmission into intensive care unit in patients with aneurysmal subarachnoid hemorrhage

Park

Lee

Kim

et al. 2021

J Cerebrovasc Endovasc Neurosurg

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Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating cerebrovascular event; patients are routinely admitted to the intensive care unit (ICU) for initial management. Because complications may be delayed, unplanned ICU readmissions can occur. Therefore, in this study we evaluate the rate of and factors associated with readmission after aSAH and identify if readmission is associated with poor clinical outcomes.Methods: We retrospectively reviewed the medical records of all patients receiving surgical or endovascular treatment for aSAH and admitted to the ICU between January 2008 and December 2019. We categorized patients by readmission and analyzed their clinical parameters.Results: Of the 345 patients who transferred to ward-level care after an initial ICU stay (Group 2), 27 (7.3%) were readmitted to the ICU (Group 1). History of hypertension (HTN), initial Glasgow Coma Scale (GCS) score, modified Fisher grade, and vasospasm therapy during first ICU stay were significantly different between the groups. The most common reason for readmission was delayed cerebral ischemia (DCI; 70.3%; OR 5.545; 95% CI 1.25−24.52; p=0.024). Comorbid HTN (OR 5.311; 95% CI 1.75−16.12; p=0.03) and vasospasm therapy during first ICU stay (OR 7.234; 95% CI 2.41−21.7; p＜0.01) also were associated with readmission. Readmitted patients had longer hospital stay and lower GCS scores at discharge (p＜0.01).Conclusions: DCI was the most common cause of ICU readmission in patients with aSAH. Readmission may indicate clinical deterioration, and patients who are at a high risk for DCI should be monitored to prevent readmission.

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Section: Discussionsupporting

confidence: 88%

“…DCI was the most common cause, accounting for 55.6% (n=15) of the patients, a result similar to that in another study. 9) This finding was not surprising, because 79.7% (n=275) of our study population had MFS Grades III or IV.…”

Section: Discussionmentioning

confidence: 58%

Readmission into intensive care unit in patients with aneurysmal subarachnoid hemorrhage

Park

Lee

Kim

et al. 2021

J Cerebrovasc Endovasc Neurosurg

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“…Stroke was recently added to the list of conditions in which 30dRAs are penalized by the ACA, which prompted numerous studies that analyzed readmission rates for various cerebrovascular insults [1,2,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. Despite recent efforts, there remains limited knowledge regarding annual trends and risk factors for 30dRA among patients with spontaneous intracerebral hemorrhage (sICH).…”

Section: Introductionmentioning

confidence: 99%

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

Furst

Jalal

et al. 2020

Heliyon

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Objective: 30-day readmission rate is a quality metric often employed to represent hospital and provider performance. Currently, little is known regarding 30-day readmissions (30dRA) following spontaneous intracerebral hemorrhage (sICH). The purpose of this study was to use a national database to identify risk factors and trends in 30dRAs following sICH. Patients and methods: 64,909 cases with a primary diagnosis of sICH were identified within the Nationwide Readmission Database (NRD) from 2010 through 2014. Charlson Comorbidity Index (CCI) was used to adjust for the severity of each patient's comorbidities. A binary logistic regression model was constructed to identify predictors of 30-day readmission. Cochran-Mantel-Haenszel test was used to generate a pooled odd ratio (OR) describing the likelihood of experiencing a 30dRA according to year. Results: The 30dRA rate following sICH decreased from 13.9% in 2010 to 12.5% in 2014 (pooled OR ¼ 0.90, 95% CI 0.87-0.94). Cerebrovascular and cardiovascular etiologies accounted for the greatest number of admissions (36.1%). Sodium abnormality, healthcare-associated infection, gastrostomy, venous thromboembolism, and ischemic stroke during the index admission were associated with 30-day readmission. Furthermore, patients who underwent ventriculostomy (OR ¼ 1.20, 95% CI 1.03-1.38) and craniotomy (OR ¼ 1.20, 95% CI 1.09-1.31) were more likely to be readmitted within 30 days. Hospital volume, hospital teaching status, mechanical ventilation, and tracheostomy did not affect 30dRAs. Median readmission costs increased from $9,875 in 2012 to $11,028 in 2014 (p ¼ 0.040). Conclusion: The overall U.S. 30dRA rate after sICH from 2010 to 2014 was 12.9% and decreased slightly during this time period, but associated costs increased. Prospective studies are required to confirm the risk factors described in this study and to identify methods for preventing readmissions.

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Endovascular and Surgical Treatment Is Predictive of Readmission Risk After Aneurysmal Subarachnoid Hemorrhage

et al. 2020

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Early versus late readmission of subarachnoid haemorrhage patients into neurocritical care

Cited by 4 publications

References 24 publications

Readmission into intensive care unit in patients with aneurysmal subarachnoid hemorrhage

Readmission into intensive care unit in patients with aneurysmal subarachnoid hemorrhage

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

Endovascular and Surgical Treatment Is Predictive of Readmission Risk After Aneurysmal Subarachnoid Hemorrhage

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