Predictors of 30-day readmission after subarachnoid hemorrhage

Mandeep Singh, James C. Guth, Eric Liotta, Adam R. Kosteva, Rebecca M. Bauer, Shyam Prabhakaran, Neil Rosenberg, Bernard Bendok, Matthew B. Maas, Andrew M. Naidech

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Readmission within 30 days is increasingly evaluated as a measure of quality of care. There are few data on the rates of readmission after subarachnoid hemorrhage (SAH). Objective: We sought to determine the predictors of 30-day readmission in patients with SAH. Methods: We prospectively identified 283 patients with SAH admitted between 2006 and 2012. Readmission was determined by means of an automated query with confirmation in the electronic medical record. Results: Overall, 21 (8 %) patients were readmitted for infection (n = 8), headache (n = 5), hydrocephalus (n = 4), cardiovascular causes (n = 2), medication-related complications (n = 1), and cerebral ischemia (n = 1). Readmission was associated with longer intensive care unit (ICU) length of stay (LOS) (15.4 [13.4-19.3] vs. 12.2 [8.2-18.5] days, P = 0.02), hospital LOS (22.2 [17.4-23.0] vs. 16.8 [12.0-24.1] days, P = 0.01), and placement of an external ventricular drain (EVD, OR 3.9, 95 % CI 1.3-12.0, P = 0.01). Readmission was not associated with admission neurologic grade, NIH Stroke scale at 14 days, modified Rankin scale at 3 months, history of cardiovascular disease, or radiographic cerebral infarction (P > 0.1). Conclusions: Demographics, severity of neurologic injury, radiographic cerebral infarction, and outcomes were not associated with readmission after SAH. Markers of a more complicated hospital course (ICU and hospital LOS, EVD placement) were associated with 30-day readmission. Most readmissions were for infections acquired after discharge. Readmission within 30 days is difficult to predict, and, since the most common reason was infection acquired after discharge, it may be difficult to prevent without an integrated health system and coordinated care.

Original languageEnglish (US)
Pages (from-to)306-310
Number of pages5
JournalNeurocritical Care
Volume19
Issue number3
DOIs
StatePublished - Dec 2013
Externally publishedYes

Fingerprint

Subarachnoid Hemorrhage
Length of Stay
Cerebral Infarction
Intensive Care Units
Infection
Integrated Delivery of Health Care
Nervous System Trauma
Patient Readmission
Electronic Health Records
Quality of Health Care
Hydrocephalus
Brain Ischemia
Nervous System
Headache
Cardiovascular Diseases
Stroke
Demography

Keywords

  • Hospital length of stay
  • Outcomes
  • Readmission
  • Rehospitalization
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

Singh, M., Guth, J. C., Liotta, E., Kosteva, A. R., Bauer, R. M., Prabhakaran, S., ... Naidech, A. M. (2013). Predictors of 30-day readmission after subarachnoid hemorrhage. Neurocritical Care, 19(3), 306-310. https://doi.org/10.1007/s12028-013-9908-0

Predictors of 30-day readmission after subarachnoid hemorrhage. / Singh, Mandeep; Guth, James C.; Liotta, Eric; Kosteva, Adam R.; Bauer, Rebecca M.; Prabhakaran, Shyam; Rosenberg, Neil; Bendok, Bernard; Maas, Matthew B.; Naidech, Andrew M.

In: Neurocritical Care, Vol. 19, No. 3, 12.2013, p. 306-310.

Research output: Contribution to journalArticle

Singh, M, Guth, JC, Liotta, E, Kosteva, AR, Bauer, RM, Prabhakaran, S, Rosenberg, N, Bendok, B, Maas, MB & Naidech, AM 2013, 'Predictors of 30-day readmission after subarachnoid hemorrhage', Neurocritical Care, vol. 19, no. 3, pp. 306-310. https://doi.org/10.1007/s12028-013-9908-0
Singh M, Guth JC, Liotta E, Kosteva AR, Bauer RM, Prabhakaran S et al. Predictors of 30-day readmission after subarachnoid hemorrhage. Neurocritical Care. 2013 Dec;19(3):306-310. https://doi.org/10.1007/s12028-013-9908-0
Singh, Mandeep ; Guth, James C. ; Liotta, Eric ; Kosteva, Adam R. ; Bauer, Rebecca M. ; Prabhakaran, Shyam ; Rosenberg, Neil ; Bendok, Bernard ; Maas, Matthew B. ; Naidech, Andrew M. / Predictors of 30-day readmission after subarachnoid hemorrhage. In: Neurocritical Care. 2013 ; Vol. 19, No. 3. pp. 306-310.
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