naa a22 4500 510799450 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s12028-013-9908-0 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9908-0 Predictors of 30-Day Readmission After Subarachnoid Hemorrhage [Elektronische Daten] [Mandeep Singh, James Guth, Eric Liotta, Adam Kosteva, Rebecca Bauer, Shyam Prabhakaran, Neil Rosenberg, Bernard Bendok, Matthew Maas, Andrew Naidech] Background: Readmission within 30days is increasingly evaluated as a measure of quality of care. There are few data on the rates of readmission after subarachnoid hemorrhage (SAH). Objective: We sought to determine the predictors of 30-day readmission in patients with SAH. Methods: We prospectively identified 283 patients with SAH admitted between 2006 and 2012. Readmission was determined by means of an automated query with confirmation in the electronic medical record. Results: Overall, 21 (8%) patients were readmitted for infection (n=8), headache (n=5), hydrocephalus (n=4), cardiovascular causes (n=2), medication-related complications (n=1), and cerebral ischemia (n=1). Readmission was associated with longer intensive care unit (ICU) length of stay (LOS) (15.4 [13.4-19.3] vs. 12.2 [8.2-18.5] days, P=0.02), hospital LOS (22.2 [17.4-23.0] vs. 16.8 [12.0-24.1] days, P=0.01), and placement of an external ventricular drain (EVD, OR 3.9, 95% CI 1.3-12.0, P=0.01). Readmission was not associated with admission neurologic grade, NIH Stroke scale at 14days, modified Rankin scale at 3months, history of cardiovascular disease, or radiographic cerebral infarction (P>0.1). Conclusions: Demographics, severity of neurologic injury, radiographic cerebral infarction, and outcomes were not associated with readmission after SAH. Markers of a more complicated hospital course (ICU and hospital LOS, EVD placement) were associated with 30-day readmission. Most readmissions were for infections acquired after discharge. Readmission within 30days is difficult to predict, and, since the most common reason was infection acquired after discharge, it may be difficult to prevent without an integrated health system and coordinated care. Springer Science+Business Media New York, 2013 Rehospitalization nationallicence Readmission nationallicence Subarachnoid hemorrhage nationallicence Outcomes nationallicence Hospital length of stay nationallicence Singh Mandeep Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Guth James Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Liotta Eric Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Kosteva Adam Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Bauer Rebecca Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Prabhakaran Shyam Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Rosenberg Neil Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Bendok Bernard Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Maas Matthew Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Naidech Andrew Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 306-310 1541-6933 19:3<306 2013 19 12028 https://doi.org/10.1007/s12028-013-9908-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9908-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Singh Mandeep Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Guth James Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Liotta Eric Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Kosteva Adam Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Bauer Rebecca Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Prabhakaran Shyam Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Rosenberg Neil Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Bendok Bernard Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Maas Matthew Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Naidech Andrew Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Abbott Hall 1116, 60611, Chicago, IL, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 306-310 1541-6933 19:3<306 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer