Thirty-day readmission after spontaneous intracerebral hemorrhage

Brain Behav. 2018 Feb 9;8(3):e00935. doi: 10.1002/brb3.935. eCollection 2018 Mar.

Abstract

Background: Intracerebral hemorrhage (ICH) is the most severe form of stroke, but data on readmission after ICH are sparse. We aimed to determine frequency, causes, and predictors of 30-day readmission after ICH.

Materials and methods: This retrospective cohort study includes all spontaneous ICH survivors admitted to the stroke unit at Haukeland University Hospital in Bergen in Norway from July 2007 to December 2013. Patients were followed by review of electronic medical charts, and the first unplanned readmission within 30 days after discharge was used as final outcome. Cox regression analysis was performed to identify predictors of 30-day readmission.

Results: We identified 226 patients with spontaneous ICH, 70 (31.0%) of whom died before discharge or were discharged to palliative care. Of the remaining 156 ICH survivors, 28 (18.0%) were readmitted within 30 days. Median time to readmission was 12 days (IQR 4.5 - 18.5). Most patients were readmitted due to infections (N = 13). None of the patients were readmitted with recurrent stroke. Pneumonia and enteral feeding during the index hospitalization were associated with readmission for infections (both p < .01). Age was the only independent predictor of readmission (HR 1.06, 95% CI 1.02 - 1.11, p = .006).

Conclusions: Almost one in five of our spontaneous ICH survivors was readmitted within 30 days, and most readmissions were caused by infections.

Keywords: hospital readmission; intracerebral hemorrhage; outcomes; stroke.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cerebral Hemorrhage / epidemiology*
  • Cohort Studies
  • Cross Infection / epidemiology
  • Disability Evaluation
  • Enteral Nutrition / statistics & numerical data
  • Female
  • Hospitals, University / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Norway
  • Patient Readmission / statistics & numerical data*
  • Pneumonia / epidemiology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Root Cause Analysis