Predictors, timing, causes and cost of 30-day readmission after acute ischemic stroke: insights from a Chinese cohort 2015-2018

Abstract

Background: This study aims to empirically investigated the risk factors, timing, and cost of the 30-day readmission after ischemic stroke.

Methods: We used the administrative claims data with 18,983 in-patients of ischemic stroke from 2015 to 2018 of a supercity in western China. The ${\chi }^2$ test was used in univariate analysis. A multivariate cox model and a multivariate linear regression method were used to identify those predictors of the 30-day readmission and the cumulative cost, respectively.

Results: The overall 30-day readmission rate was 18.8%, of which 36.4% and 60.9% were readmitted within 7 and 14 days, respectively. Nearly 50% were readmitted for recurrent ischemic stroke. Male, rural areas, aged under 50, resident's insurance scheme, primary hospitals, LOS under 1 week or over two weeks, and comorbidities including congestive heart failure, solid tumor, fluid and electrolyte disorders, and depression were independent predictors of 30-day readmission. We also found that the 30-day readmission was associated with an 76% increase in the cumulative hospitalization cost (P < 0.001) after multivariate adjustment analysis.

Conclusions: The findings highlight the importance of the readmission of ischemic stroke and corresponding policies and interventions, and our work could provide a potential manage path for the reduction of readmission rate.

Keywords: 30-day readmission; Ischemic stroke; causes; cost; risk factors.