To identify potentially modifiable factors contributing to post-stroke readmissions in order to reduce the 30-day readmission rate and improve the transition from the inpatient to outpatient settings for these stroke patients.

With increasing prevalence and ability to recognize and treat acute stroke, there is increasing survivorship and increased hospital discharges, creating more potential for readmissions. Increased readmission rates negatively impact patients and their families and are associated with increased strain on hospital systems. There is also no standard method of accurately identifying and quantifying stroke readmissions data.

In this retrospective study conducted at an Advanced Comprehensive Stroke Center, a stroke program-specific report was used to capture patients with a primary discharge diagnosis code related to ischemic stroke over a one-year period. Patients with a 30-day readmission were then included. Data points were captured for each readmitted patient and further categorized into common reasons for readmissions.

Of 614 patients discharged with a diagnosis related to ischemic stroke, only 34 patients were identified with a readmission within 30 days of their initial discharge. The most common categories for readmission were infection (n=8), falls (n=4), readmissions for planned procedures (n=3), while new strokes constituted a smaller category (n=2). Of note, the dataset also captured 4 patients with initial planned admissions for vascular procedures who were then readmitted with post-operative complications. All other patients had unique readmission diagnoses unable to be further categorized.

Most stroke readmissions are not for new strokes, while the most common cause is infection. The very few preventable readmissions likely reflect underreported data as patients may be readmitted to other hospitals. The diagnoses used to capture at the institution level are also flawed as planned readmissions and those for procedures are also included, highlighting further need for standardization in how stroke readmissions data is reported and analyzed.