Abstract TP214: Neurology Follow-up After Stroke is Associated With Reduced Mortality and Improved Outcomes in Stroke Survivors

Introduction: Current stroke guidelines emphasize a primary care-based approach to follow-up care but provide little information regarding neurology-specific follow-up, and the efficacy of follow-up care is largely unknown. This study examines the rates of follow-up with neurologists and non-neurology providers and their association with patient outcomes, as well as the impact of early follow-up phone calls with neurology on patient outcomes. Methods: We conducted a retrospective cohort study using electronic health records of patients discharged home after neurovascular admission from a tertiary care hospital from October 2020 to October 2023. Patients were then subsequently contacted via a guideline-recommended seven-day phone call. Clinical demographics, follow-up with a neurologist or non-neurologist, emergency department (ED) presentations, and mortality were collected and analyzed using Chi-square analysis for patients who were both successfully and unsuccessfully reached by phone. Results: 491 patients were identified for this study, all of whom were called via guideline-recommended follow-up. 248 patients (50.5%) were successfully reached, while 243 patients (49.5%) were unable to be contacted despite multiple attempts. Among patients who were not reached, there were more deaths among those who did not attend any follow-up (7/10, 70%) compared to those who attended follow-up with a non-neurologist (16/152, 10.5%; p < 0.001). There were also more deaths among patients who did not attend neurology follow-up (13/63, 20.6%) compared to patients who did attend follow-up with neurology (15/162, 9.3%; p = 0.020). Similarly, out of the patients who were contacted by phone, there were more deaths among patients who did not attend neurology follow-up (8/59, 13.6%) than those who did (8/182, 4.4%; p = 0.014). Among those who did not attend any follow-up, patients who were not contacted by follow-up phone call had higher mortality (7/10, 70%) than those who were reached (0/11, 0%; p < 0.001). Conclusion: Our findings provide evidence that patients who do not attend follow-up with neurology after a stroke experience worse outcomes, especially higher mortality rates, which is consistent with results from a previous study evaluating a smaller cohort of only patients contacted by phone. Mortality trends remained the same regardless of whether the patient was reached by phone, indicating a need for interventions that directly improve neurology follow-up rates.