2023 American Academy of Neurology Abstract Website

Objective:

Evaluate how substance use, demographics, and other medical diagnoses affect the rate of hospital readmission after stroke.

Background:

Strokes are life-changing events that significantly increase disability and mortality. This study aims to identify the most significant risk factors that are associated with readmission rates after an initial stroke.

Design/Methods:

A retrospectively-reviewed study of admissions for stroke from January 1, 2013 to December 31, 2021 at an academic comprehensive stroke center was conducted. Patient characteristics, drug use, and medical diagnoses were assessed. Rates of readmission were evaluated with a negative binomial log regression adjusted by time in study.

Results:

5,474 stroke patients were included with a mean age of 69.7, 52.3% (n=2,864) were males, 19.26% (n=1,041) screened positive for drug use, 6.4% (n=345) for polysubstance drug use, 11.0% (n=603) had chronic ischemic heart disease, 36.5% (n=1,934) had Medicare, and 31.2% (n=1,655) had Medi-Cal, respectively. Multivariate analysis showed a significant positive association with hospital readmission rates following stroke and drug use (p<0.001;Rate Ratio (RR)=1.66;95%CI=1.48-1.86), polysubstance drug use (p<0.001;RR=2.07;95%CI=1.74-2.45), chronic ischemic heart disease (p<0.001;RR=1.77;95%CI=1.55-2.03), Medicare (p<0.001;RR=2.49;95%CI=2.19-2.84), and Medi-Cal (p<0.001;RR=2.74; 95%CI=2.40-3.13).

Conclusions:

Drug use, polysubstance use, chronic ischemic heart disease, Medicare and Medi-Cal are associated with elevated rates of readmissions following stroke by 66%, 107%, 77%, 149%, and 174%, respectively. This study identifies patients who are more likely to be readmitted after a stroke, allowing better planning and allocation of resources to meet their needs.