Abstract WP205: Principal Diagnosis and Independent Predictors for 30-Day Readmissions in Cryptogenic Stroke

Background: Cryptogenic stroke is defined as cerebral infraction that can’t be attributed to large artery atherosclerosis, small artery disease, or cardio-embolism, despite a standard cardiovascular and serologic workup. Our objective was to identify rates and causes for readmissions of cryptogenic stroke. Methods: A retrospective analysis was conducted using National Readmission Database 2018 with ICD-10 codes. Readmission rate and principal diagnosis for 30-day readmission for cryptogenic stroke were primary outcomes. Secondary outcomes were in-hospital mortality, and independent predictors of readmission. Multivariate logistic regression analysis was used for assessment. Results: Within 30 days, 21,418 out of 206,627 patients were readmitted, giving a 30-day readmission rate of 10.4%. For the index admissions, 49.9% were females, and mean age was 70 years. The in-hospital mortality rate for index admissions was 2.4% while it was 4.9% for the readmissions. The ten most common principal diagnosis for 30-day readmissions were subsequent admission for cryptogenic stroke (10.5%), sepsis (7.1%), acute kidney injury (3.2%), transient ischemic attack (1.9%), urinary tract infection (1.8%), aspiration pneumonitis (1.7%), hypertensive heart and chronic kidney disease (HHD/CKD) with heart failure (1.6%), left carotid artery stenosis/occlusion (1.5%), non-specific cerebral infarction (1.3%), and HHD with heart failure (1.2%). The independent predictors for readmission were heart failure, ischemic heart disease, ventricular arrhythmia, infective endocarditis, peripheral artery disease, venous thromboembolism, pulmonary embolism, and diabetes mellitus. Conclusions: Readmission rate for cryptogenic stroke is 10.4% within 30 days and is associated with higher mortality and costs. Most common principal diagnosis for readmission are cryptogenic stroke, sepsis, acute kidney injury, transient ischemic attack, urinary tract infection, and aspiration pneumonitis. The independent predictors for readmission are heart failure, ischemic heart disease, ventricular arrhythmia, infective endocarditis, peripheral artery disease, venous thromboembolism, pulmonary embolism, and diabetes mellitus.