Predictors of unplanned hospital readmissions and emergency department revisits in patients with acute ischemic stroke.

Objectives: We aim to identify factors associated with emergency department (ED) revisits and hospital readmissions after acute ischemic stroke (AIS) diagnosis and to determine if early outpatient follow-up can reduce readmissions. Methods: We retrospectively identified all AIS patients discharged from a hospital network, from October 1, 2022 to March 31, 2024. Baseline characteristics, inpatient metrics and post-discharge outpatient follow-up were assessed to identify factors associated with ED revisits and readmissions to the healthcare system within 90-days. Results: Of 1,973 patients, 464 (23.5%) had ED visits within 90 days and 263 (13.3%) had hospital readmission within 90 days. The median age was 68 [IQR 58, 77]. In multiple logistic regression analyses, factors independently associated with 90-day ED visit were history of heart failure (HF) (OR 1.46, 95% CI 1.11-1.93; Conclusion: Patients with certain comorbidities including HF, DM, AF and those with a higher CCI score have a higher likelihood of a 90-day ED revisit and hospital readmission. Unplanned hospital readmissions may be preventable with early outpatient visits in a dedicated stroke clinic after discharge for AIS patients.