Garg Aayushi, Starr Matthew, Rocha Marcelo, Ortega-Gutierrez Santiago
From the Department of Neurology (A.G.) and Department of Neurology, Neurosurgery, and Radiology (S.O.-G.), University of Iowa Hospitals and Clinics, Iowa City; and Department of Neurology (M.S., M.R.), University of Pittsburgh Medical Center, PA.
Neurology. 2021 Jun 14;96(24):e2912-e2919. doi: 10.1212/WNL.0000000000012107.
For evaluation of 90-day readmissions after an inpatient admission for reversible cerebral vasoconstriction syndrome (RCVS), hospitalizations due to RCVS were identified from the Nationwide Readmissions Database from 2016 to 2017.
The primary outcome of interest was nonelective readmission within 90 days of index hospitalization discharge. Survival analysis was performed, and multivariable Cox proportional hazards regression was used to determine the factors associated with readmission.
Among the 1,157 hospitalizations due to RCVS during the study period (mean ± SD age 48.6 ± 16.1 years, women 76.4%), 164 (14.2%) patients had nonelective readmission within 90 days of discharge. The most common reasons for readmissions included acute cerebrovascular events (18.9%), continued or recurrent symptoms of RCVS (13.4%), infections (11.6%), and headache (9.8%). Diabetes, history of tobacco use, opioid use, and longer length of index hospitalization were independent predictors of 90-day readmission. For readmissions, the mean (SD) length of stay was 5.2 (6.1) days, and the mean (SD) cost per hospitalization was $14,214 ($15,140). There was no in-hospital mortality; however, 37.2% of patients were not discharged to home.
Nearly 14% of patients with RCVS are readmitted within 90 days of discharge, and a significant proportion of these readmissions are due to the ongoing/recurrent symptoms or neurologic sequelae of RCVS. Given that these patients are at a risk of early recurrence/worsening of their symptoms, an early postdischarge follow-up plan may need to be integrated into their care.
为评估可逆性脑血管收缩综合征（RCVS）住院患者90天内的再入院情况，从2016年至2017年的全国再入院数据库中识别出因RCVS导致的住院病例。
主要关注的结局是首次住院出院后90天内的非选择性再入院。进行了生存分析，并使用多变量Cox比例风险回归来确定与再入院相关的因素。
在研究期间因RCVS导致的1157例住院病例中（平均±标准差年龄48.6±16.1岁，女性占76.4%），164例（14.2%）患者在出院后90天内有非选择性再入院。再入院的最常见原因包括急性脑血管事件（18.9%）、RCVS持续或复发症状（13.4%）、感染（11.6%）和头痛（9.8%）。糖尿病、吸烟史、使用阿片类药物以及首次住院时间较长是90天再入院的独立预测因素。对于再入院患者，平均（标准差）住院时间为5.2（6.1）天，每次住院的平均（标准差）费用为14214美元（15140美元）。没有院内死亡病例；然而，3，37.2%的患者未出院回家。
近14%的RCVS患者在出院后90天内再次入院，其中很大一部分再入院是由于RCVS的持续/复发症状或神经后遗症。鉴于这些患者有症状早期复发/恶化的风险，则可能需要将出院后早期随访计划纳入其护理中。
