Age-related differences in the rate and diagnosis of 30-day readmission after hospitalization for acute ischemic stroke. Issue 7 (October 2018)

• Record Type: Journal Article
• Authors: Hirayama, Atsushi; Goto, Tadahiro; Faridi, Mohammad K; Camargo, Carlos A; Hasegawa, Kohei
• Is Part Of: International journal of stroke. Volume 13:Issue 7(2018)
• Page Start: 717
• Page End: 724
• Publication Date: 2018-10
• Subjects: Ischemic stroke -- readmission -- age -- sex; 616.8005
• DOI: 10.1177/1747493018772790
• Languages: English
• ISSNs: 1747-4930

Abstract

Background: Little is known about the association between age and readmission within 30 days after hospitalization for acute ischemic stroke. Aim: To examine the age-related differences in rate and principal reason of 30-day readmissions in patients hospitalized for acute ischemic stroke. Methods: In this retrospective, population-based cohort study using State Inpatient Databases from eight US states, we identified all adults hospitalized for acute ischemic stroke. We grouped the patients into four age categories: < 65, 65–74, 75–84, and ≥85 years. Outcomes were any-cause readmission within 30 days of discharge from the index hospitalization for acute ischemic stroke and the principal diagnosis of 30-day readmission. Results: We identified 620, 788 hospitalizations for acute ischemic stroke. The overall 30-day readmission rate was 16.6% with an increase with advanced age. Compared to patients aged <65 years, the readmission rate was significantly higher in age 65–74 years (OR 1.19; 95% CI 1.16–1.21), in age 75–84 years (OR 1.29; 95% CI 1.27–1.31), and in ≥ 85 years (OR 1.24; 95% CI 1.22–1.27; all P<0.001). There was heterogeneity in the age-readmission rate association between men and women (Pinteraction < 0.001). Overall, 45.8% of readmissions were assigned stroke-related conditions or rehabilitation care. Compared to younger adults, older adults were more likely to present with non-stroke-related conditions (46.1% in < 65 years, 50.6% in 65–74 years, 57.1% in 75–84 years, and 62.9% in ≥ 85 years; P<0.001). Conclusions: Advanced age was associated with a higher 30-day readmission rate after acute ischemic stroke. Compared with younger adults, older adults were more likely to be readmitted for non-stroke-related conditions.