Readmission After Mechanical Thrombectomy for Acute Ischemic Stroke: A Nationwide Readmission Database Analysis (P4.205)

Objective: To quantify 30- and 90-day readmissions after thrombectomy and identify factors associated with readmissions. Background: Mechanical thrombectomy after acute ischemic stroke has been shown to improve clinical outcomes. However, rates and causes of hospital readmissions after thrombectomy remain unknown. Design/Methods: Retrospective observational analysis of adult patients (ages 18 and older) between January and November 2014, using data from the 2014 Nationwide Readmissions Database (NRD), an all-payer, all-ages, longitudinal administrative database with data on more than 35 million weighted US discharges yearly. 30- and 90-day readmission data were calculated using NRD survey weighting methods and examined according to patient, clinical, and hospital characteristics using descriptive statistics. A weighted unconditional logistic regression models to estimate the crude odds of all-cause readmissions was constructed to examine associations between select characteristics and readmission. Results: 4,246 patients underwent mechanical thrombectomy in 2014. The mean age was 66.9 and 49.1% were women. The rates of all-cause non-elective readmission were 12.5% and 20.7% at 30 and 90 days, respectively. The top two causes of readmission were sepsis and stroke. Female sex (AOR 1.34, 1.02–1.77 at 30 days), discharge to inpatient post-acute care facility (AOR 1.61, 1.07–2.41 at 30 days, AOR 1.99, 1.47–2.69 at 90 days), and longer lengths of stay (AOR 1.52, 1.04–2.23 at 30 days, AOR 1.67, 1.14–2.43 at 90 days) were associated with a higher risk of readmission. Conclusions: The rates and reasons for readmission are not different among stroke patients who undergo mechanical thrombectomy compared to historical data on those that do not. Additionally, there is no association between procedure specific complications and readmission. This study provides a preliminary analysis for evaluating the public health impact of mechanical thrombectomy and highlights the potential of thrombectomy to improve outcomes after acute ischemic stroke. Disclosure: Dr. Ramchand has nothing to disclose. Dr. Thibault has nothing to disclose. Dr. Crispo has nothing to disclose. Dr Levine has nothing to disclose. Dr. Hurst has nothing to disclose. Dr. Mullen has nothing to disclose. Dr. Kasner has nothing to disclose. Dr. Wright Willis has nothing to disclose.