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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Hospital Readmission after Intracerebral Hemorrhage
Anna T Bjerkreim1, Lars Thomassen1, Ulrike Waje-Andreassen2
1Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Insights
Intracerebral hemorrhage (ICH) readmissions are common, with infections causing early rehospitalizations and recurrent strokes or cardiovascular issues causing late ones. Predictors and causes differ significantly between early and late readmissions.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Public Health
Background:
- Intracerebral hemorrhage (ICH) is a severe stroke type with limited research on patient readmission.
- Understanding readmission patterns is crucial for improving post-discharge care and patient outcomes.
Purpose of the Study:
- To determine the frequency, causes, and predictors of early (≤90 days) and late (91-365 days) readmissions after ICH.
- To identify distinct factors influencing early versus late rehospitalization in ICH survivors.
Main Methods:
- Prospective cohort study of ICH patients included in the Bergen Norwegian Stroke Research Registry (NORSTROKE).
- 1-year follow-up using medical chart reviews to identify unplanned readmissions.
- Logistic regression analysis to identify predictors of early and late readmission.
Main Results:
- 40.6% of discharged ICH patients experienced at least one unplanned readmission within a year.
- Infections were the primary cause of early readmission; recurrent stroke and cardiovascular disease dominated late readmissions.
- Nursing home discharge predicted early readmission, while diabetes and longer index admission predicted late readmission.
Conclusions:
- Readmission after ICH is frequent, with a substantial proportion occurring early.
- Early and late readmissions present different etiological and predictive profiles, indicating distinct underlying mechanisms.
- Identifying these differences is key for targeted interventions to reduce ICH readmission rates.
Background:
Intracerebral hemorrhage (ICH) is the most severe form of stroke, but limited literature exists on readmission after ICH. We aimed to assess frequencies, causes, and predictors of early and late readmissions within 1 year after ICH.
Methods:
All patients admitted to the Department of Neurology at Haukeland University Hospital with acute stroke were prospectively included in the Bergen Norwegian Stroke Research Registry (NORSTROKE) registry. Surviving patients diagnosed with ICH were followed by medical chart reviews for 1 year. The first unplanned readmission was used as final outcome, and readmitted patients were defined as early readmitted (≤90 days) and late readmitted (91-365 days). Logistic regression was performed to assess predictors for early and late readmission.
Results:
Of 121 patients discharged alive, 27 were early readmitted, and 17 were late readmitted. Within 1 year, 40.6% had at least 1 unplanned readmission. The most frequent cause of early readmission was infection, and the most frequent causes for late readmission were recurrent stroke and cardiovascular disease. Nursing home discharge was the only independent predictor of early readmission. Diabetes mellitus and increased length of the index admission were independent predictors of late readmission. Early readmitted patients were older and had more severe stroke and lower levels of fibrinogen on index admission compared with patients who were readmitted late.
Conclusions:
Readmission after ICH is frequent, and many patients are early readmitted. Early and late readmissions differed in both causes and predictors for readmission, reflecting different underlying mechanisms for readmission.
