The 30-day readmission rate after mechanical thrombectomy was 8.3%, with independent predictors including decompressive hemicraniectomy (OR 9.3) and intracranial stenting (OR 4.6).
Cohort (n=703)
No
What are the rate, causes, and predictors of 30-day readmission in patients with stroke undergoing mechanical thrombectomy?
In patients undergoing mechanical thrombectomy for stroke, the 30-day readmission rate is 8.3%, primarily driven by recurrent cerebrovascular events and predicted by factors such as smoking, distal embolization, hemicraniectomy, and intracranial stenting.
BACKGROUND AND OBJECTIVES: The 30-day readmission rate has emerged as a metric of quality care and is associated with increased health care expenditure. We aim to identify the rate and causes of 30-day readmission after mechanical thrombectomy and provide the risk factors of readmission to highlight high-risk patients who may require closer care. METHODS: This is a retrospective study from a prospectively maintained database of 703 patients presenting for mechanical thrombectomy between 2017 and 2023. All patients who presented with a stroke and underwent a mechanical thrombectomy were included in this study. Patients who were deceased on discharge were excluded from this study. RESULTS: Our study comprised 703 patients, mostly female (n = 402, 57.2%) with a mean age of 70.2 years ±15.4. The most common causes of readmission were cerebrovascular events (stroke n = 21, 36.2%, intracranial hemorrhage n = 9, 15.5%, and transient ischemic attack n = 1, 1.7%).Other causes of readmission included cardiovascular events (cardiac arrest n = 4, 6.9% and bradycardia n = 1, 1.7%), infection (wound infection postcraniectomy n = 3, 5.2%, and pneumonia n = 1, 1.7%). On multivariate analysis, independent predictors of 30-day readmission were history of smoking (odds ratio OR: 2.2, 95% CI: 1.1-4.2) P = .01), distal embolization (OR: 3.2, 95% CI: 1.1-8.7, P = .03), decompressive hemicraniectomy (OR: 9.3, 95% CI: 3.2-27.6, P < .01), and intracranial stent placement (OR: 4.6, 95% CI: 2.4-8.7) P < .01). CONCLUSION: In our study, the rate of 30-day readmission was 8.3%, and the most common cause of readmission was recurrent strokes. We identified a history of smoking, distal embolization, decompressive hemicraniectomy, and intracranial stenting as independent predictors of 30-day readmission in patients with stroke undergoing mechanical thrombectomy.
Naamani et al. (2024) conducted a cohort in Stroke undergoing mechanical thrombectomy (n=703). Mechanical thrombectomy was evaluated on 30-day readmission. The 30-day readmission rate after mechanical thrombectomy was 8.3%, with independent predictors including decompressive hemicraniectomy (OR 9.3) and intracranial stenting (OR 4.6).