Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 6
Disclosures: Nneka L. Ifejika, MD MPH: Nothing to disclose
Objective: Identify characteristics of stroke patients more likely to be readmitted to an inpatient rehabilitation facility (IRF) after a second acute hospitalization.
Design: Retrospective observational study
Setting: Seven center urban IRF network.
Participants: Stroke patients identified by ICD9/10 code, admitted to an in-network IRF, acutely re-hospitalized, then readmitted or not readmitted to an in-network IRF within 90 days, between 10/1/2014 & 12/31/2017 (n=380).
Interventions: Univariable analyses used descriptive statistics for demographics, risk factors and functional independence measure (FIM) scores. Multivariable linear regression model included variables with P<.1. Odds ratio and 95% CI were calculated; P<.05 equaled statistical significance.
Main Outcome Measures: Clinical, functional and socioeconomic variables that affect IRF readmission.
Results: 192 patients were readmitted to IRFs, 188 were not readmitted. Patients readmitted to IRFs were younger (P<.001), had hemorrhagic strokes (P=.01), non-Medicare insurance (P<.0001) and lower frequency of cardiac disease (P=.008). Patients not readmitted to IRFs had higher total FIM (admission P=.002; discharge P=.005) and higher admission/discharge motor FIM scores (P<.0001). Multivariable Regression: Non-Medicare insurance had 39% higher readmission odds compared to Medicare insurance (OR 1.39; 95% CI 1.01-1.92; P=.04) Hemorrhagic stroke had 33% higher readmission odds compared to ischemic stroke (OR 1.33; 95% CI 1.21-1.47; P<.0001). There were 4% higher readmission odds per point of total discharge FIM increase past 40.6 (OR 1.04; 95% CI 1.01-1.07; P=.02). Odds of IRF readmission decreased by 7% per point increase of motor discharge FIM past 25.6 (OR 0.93; 95% CI 0.89-0.98; P=.003); and by 1% per year after age 60.6 years (OR 0.99; 95% CI 0.98-0.99; P=.001).
Conclusions: Hemorrhagic stroke, non-Medicare insurance and higher total discharge FIM during the first IRF admission independently predicted inpatient rehabilitation facility readmission. Higher motor discharge FIM during the first IRF stay and advancing age selected against IRF readmission. Studies that examine the interplay of stroke type with non-motor impairments, and the influence of insurance plan on IRF readmission are indicated.
Level of Evidence: Level II
To cite this abstract in AMA style:Ifejika NL, Bhadane M, Cai CC, Watkins JN, Grotta JC. Characteristics of Acute Stroke Patients Readmitted to Inpatient Rehabilitation Facilities [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/characteristics-of-acute-stroke-patients-readmitted-to-inpatient-rehabilitation-facilities/. Accessed September 28, 2023.
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