Abstract Details

Title Readmissions After Central Retinal Artery Occlusion versus Acute Ischemic Stroke: Nationally Representative Data

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S52 - Acute Non-Interventional Stroke Care (4:25 PM-4:36 PM)

Poster/Presentation
Number 006

Background Complications and healthcare utilization after CRAO are not well understood. Although CRAO shares pathophysiology with AIS, comparative data is scarce, and valid data could improve guidelines for secondary prevention.

Objective Summarize 30-day readmission rates and reasons after index central retinal artery occlusion (CRAO) admissions, compared to acute ischemic stroke (AIS) admissions.

Design/Methods The National Readmissions Database contains data on ~50% of US hospitalizations from 2013-2015. We used validated International Classification of Diseases 9^th Clinical Modification codes to identify index CRAO and AIS admissions, comorbidities, and procedures, and Clinical Comorbidity Software codes to identify reasons for 30-day readmissions after index admission. We used survey weighted methods to estimate 30-day all-cause readmission rates.

Results There were 4871 CRAO and 1239963 AIS admissions. After CRAO, 18.5% had >1 all-cause readmission up to 1 year (6.3% with >2 readmissions) versus 24.2% after AIS (7.7% with >2 readmissions). The 30-day all-cause readmission rate was 8.9% (95% CI 7.5-10.4%) after CRAO and 12.2% (12.1-12.3%) after AIS. CRAO patients were most commonly readmitted for “occlusion or stenosis of pre-cerebral arteries” (21.3% of readmissions). The most common readmission reason was “acute cerebrovascular disease” in the AIS cohort (20.3%), higher than in the CRAO cohort (7.4%). Vascular procedures performed in CRAO readmissions versus AIS readmissions include: “procedure on single vessel" (8.4% of all CRAO readmissions, versus 3.2% in AIS), carotid endarterectomy (8.4%, versus 2.5%), "insertion of vascular stent" (1.9% versus 0.7%), and cerebral angiography (2.1% versus 1.3%).

Conclusions

All-cause readmissions were more common after AIS than CRAO, but the 30-day readmission rate after CRAO was high at almost 10%. Vascular procedures including carotid endarterectomy, stent insertion and angiogram were more common in CRAO readmissions.

Authors/Disclosures
Emily Schorr, MD (UCSD) PRESENTER	No disclosure on file
Kyle Rossi, MD (UMass Memorial Medical Center)	No disclosure on file
Laura Stein, MD (Mount Sinai School of Medicine)	The institution of Dr. Stein has received research support from American Heart Association.
Mandip S. Dhamoon, MD, MPH	Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Faegre Baker Daniels LLP. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Wellstar Health System Inc. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Fabiani Cohen & Hall, LLP. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Kramer, Dillof, Livingston & Moore. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Robins Kaplan. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Parker Waichman LLP. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Heidell, Pittoni, Murphy & Bach, LLP.

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