Arevalo C Yurany A, Nanavati Hely D, Lin Chen
Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USA.
Neurohospitalist. 2024 Jul;14(3):259-263. doi: 10.1177/19418744241232020. Epub 2024 Feb 5.
Understanding various aspects associated with readmission after acute ischemic stroke (AIS) is an important priority. Our study aims to examine whether 60-day readmission rates differed among patients with AIS who were treated with different acute reperfusion treatment modalities along with associated clinical factors.
This is a retrospective analysis of a continuous cohort of patient with AIS, who received either intravenous recombinant tissue plasminogen activator (IV rtPA), endovascular treatment (EVT) or both, and were discharged alive. Patients readmitted within 60 days were identified as the readmission group. Multivariable logistic regression was used to identify all-cause readmission post-stroke between treatment groups.
The final cohort comprised of 358 patients with AIS receiving IV rtPA only (N = 160), EVT only (N = 106), or both (N = 92). Fifty-six patients were readmitted to the hospital within 60-day follow-up period. The adjusted logistic regression model indicated that compared to patients who received IV tPA only, patients receiving both IV rtPA and EVT had significantly lower odds (OR = .27; 95% CI = .10, .75)) of getting readmitted within 60-day post-discharge from stroke admission.
In this sample of AIS hospitalizations, treatment-type was positively associated with 60-day readmission. Future studies are necessary to understand whether treatment-related adverse events, and readmission are avoidable.
了解急性缺血性卒中（AIS）后再入院的各个方面是一项重要的优先事项。我们的研究旨在探讨接受不同急性再灌注治疗方式及相关临床因素的AIS患者60天再入院率是否存在差异。
这是一项对连续队列的AIS患者进行的回顾性分析，这些患者接受了静脉注射重组组织型纤溶酶原激活剂（IV rtPA）、血管内治疗（EVT）或两者皆有，并存活出院。在60天内再次入院的患者被确定为再入院组。多变量逻辑回归用于确定治疗组之间卒中后的全因再入院情况。
最终队列包括358例AIS患者，其中仅接受IV rtPA治疗的有160例（N = 160），仅接受EVT治疗的有106例（N = 106），接受两种治疗的有92例（N = 92）。56例患者在60天随访期内再次入院。调整后的逻辑回归模型表明，与仅接受IV tPA治疗的患者相比，同时接受IV rtPA和EVT治疗的患者在卒中入院出院后60天内再次入院的几率显著降低（OR = 0.27；95% CI = 0.10，0.75））。
在这个AIS住院样本中，治疗类型与60天再入院呈正相关。未来有必要进行研究以了解与治疗相关的不良事件以及再入院是否可以避免。
