Early Risk of Readmission Following Hospitalization for Reversible Cerebral Vasoconstriction Syndrome

ObjectiveFor 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.MethodsThe 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.ResultsAmong the 1,157 hospitalizations due to RCVS during the study period (mean & PLUSMN; SD age 48.6 & PLUSMN; 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.ConclusionNearly 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.

Automated summary

Nearly 14% of patients with reversible cerebral vasoconstriction syndrome (RCVS) are readmitted within 90 days of discharge, with factors such as diabetes, history of tobacco use, opioid use, and longer length of index hospitalization being independent predictors of readmission. The most common reasons for readmissions are acute cerebrovascular events, continued or recurrent RCVS symptoms, infections, and headache, with a significant proportion of patients not being discharged to home after readmission.