Hospital readmissions after spontaneous intracerebral hemorrhage in Southern Portugal

Publication date: June 2018
Source:Clinical Neurology and Neurosurgery, Volume 169
Author(s): Hipólito Nzwalo, Jerina Nogueira, Patrícia Guilherme, Pedro Abreu, Catarina Félix, Fátima Ferreira, Sara Ramalhete, Ana Marreiros, Turgut Tatlisumak, Lars Thomassen, Nicola Logallo
ObjectivesSpontaneous intracerebral hemorrhage (SICH) survivors are at risk of hospital readmissions. Data on readmissions after SICH is scarce. We aimed to study the frequency and predictors of readmissions after SICH in Algarve, Portugal.Patients and methodsRetrospective study of a community representative cohort of SICH survivors (2009–2015). The first unplanned readmission in the first year after discharge was the outcome. Cox regression analysis was performed to identify predictors of 1-year readmission.ResultsOf the 357 SICH survivors followed, 116 (32.5%) were readmitted within the first-year. Sixty-seven (18.8%) of the survivors were early readmitted (<90 days), corresponding to 57.8% or all readmissions. Common causes were pneumonia, endocrine/nutritional/metabolic and cardiovascular complications. The risk of readmission was increased by prior to index SICH history of ≥ 3 previous emergency department visits (hazards ratio (HR) = 2.663 (1.770–4.007); P < 0.001), pneumonia during index hospitalization (HR = 2.910 (1.844–4.592); P < 0.001) and reduced in patients discharge home (HR = 0.681 (0.366–0.976); P = 0.048).ConclusionsThe rate of readmissions after SICH is high, predictors are identifiable and causes are potentially preventable. Improvement of care can potentially reduce this burden.



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