Dataset Information

In-hospital outcomes and 30-day readmission rates among ischemic and hemorrhagic stroke patients with delirium.

ABSTRACT:

Objective

Delirium is associated with poor outcomes among critically ill patients. However, it is not well characterized among patients with ischemic or hemorrhagic stroke (IS and HS). We provide the population-level frequency of in-hospital delirium and assess its association with in-hospital outcomes and with 30-day readmission among IS and HS patients.

Methods

We analyzed Nationwide in-hospital and readmission data for years 2010-2015 and identified stroke patients using ICD-9 codes. Delirium was identified using validated algorithms. Outcomes were in-hospital mortality, length of stay, unfavorable discharge disposition, and 30-day readmission. We used survey design logistic regression methods to provide national estimates of proportions and 95% confidence intervals (CI) for delirium, and odds ratios (OR) for association between delirium and poor outcomes.

Results

We identified 3,107,437 stroke discharges of whom 7.45% were coded to have delirium. This proportion significantly increased between 2010 (6.3%) and 2015 (8.7%) (aOR, 95% CI: 1.04, 1.03-1.05). Delirium proportion was higher among HS patients (ICH: 10.0%, SAH: 9.8%) as compared to IS patients (7.0%). Delirious stroke patients had higher in-hospital mortality (12.3% vs. 7.8%), longer in-hospital stay (11.6 days vs. 7.3 days) and a significantly greater adjusted risk of 30-day-readmission (16.7%) as compared to those without delirium (12.2%) (aRR, 95% CI: 1.13, 1.11-1.15). Upon readmission, patients with delirium at initial admission continued to have a longer length of stay (7.7 days vs. 6.6 days) and a higher in-hospital mortality (9.3% vs. 6.4%).

Conclusion

Delirium identified through claims data in stroke patients is independently associated with poor in-hospital outcomes both at index admission and readmission. Identification and management of delirium among stroke patients provides an opportunity to improve outcomes.

SUBMITTER: Vahidy FS

PROVIDER: S-EPMC6855446 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

In-hospital outcomes and 30-day readmission rates among ischemic and hemorrhagic stroke patients with delirium.

Vahidy Farhaan S FS Bambhroliya Arvind B AB Meeks Jennifer R JR Rahman Omar O Ely E Wesley EW Slooter Arjen J C AJC Tyson Jon E JE Miller Charles C CC McCullough Louise D LD Savitz Sean I SI Khan Babar B

PloS one 20191114 11

<h4>Objective</h4>Delirium is associated with poor outcomes among critically ill patients. However, it is not well characterized among patients with ischemic or hemorrhagic stroke (IS and HS). We provide the population-level frequency of in-hospital delirium and assess its association with in-hospital outcomes and with 30-day readmission among IS and HS patients.<h4>Methods</h4>We analyzed Nationwide in-hospital and readmission data for years 2010-2015 and identified stroke patients using ICD-9 ...[more]

PMID: 31725810

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Dataset Information

In-hospital outcomes and 30-day readmission rates among ischemic and hemorrhagic stroke patients with delirium.

Objective

Methods

Results

Conclusion

Publications

In-hospital outcomes and 30-day readmission rates among ischemic and hemorrhagic stroke patients with delirium.

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