Abstract WP385: Burden of Rehospitalizations for Venous Thromboembolism Among Patients With Ischemic Stroke

Introduction: Patients hospitalized for ischemic stroke are at risk for venous thromboembolism (VTE) that remains high after discharge. Without adequate VTE prophylaxis covering the entire risk period, including after discharge, patients are at risk of VTE-related rehospitalization. The goal of this study was to analyze the frequency and associated cost of VTE-related readmissions among patients with ischemic stroke in the US. Methods: Patients hospitalized for ischemic stroke, based on the primary hospital discharge diagnosis codes, were identified from the MarketScan databases (7/1/2011 to 3/31/2015). Eligible patients were ≥40 y and had continuous insurance enrollment ≤6 mo prior to initial (index) hospitalizations (baseline period) and >6 mo after discharge (follow-up period). The study endpoints were: the proportion of patients readmitted for the primary VTE or any position VTE (VTE-related) during the follow-up period, and the associated resources and costs of readmissions. Results: For this retrospective analysis, data from 1,030 patients hospitalized for ischemic stroke were available; mean age: 71.6 y (66.2% were ≥65 y), 52.1% female, mean Charlson Comorbidity Index score: 3.3. For index hospitalization, 55.3% of patients were hospitalized for 1-3 d, and 33.3% for 4-7 d. During index hospitalization, 1.3% of patients had a VTE. In the 6 months following discharge, 1.4% had a VTE-related hospital readmission, of which 50% were for a primary diagnosis of VTE. Over one-third (35.7%) of the VTE-related readmissions occurred ≤30 d of discharge. For VTE-related readmissions, mean length of hospital stay (LOS) was 14.9 d and the mean total cost for a hospital readmission was $39,692. For primary VTE readmissions, the mean LOS was 4.9 d and the mean total cost of a readmission was $12,384. Conclusions: In this real-world study, 1.4% of patients hospitalized for ischemic stroke had a VTE-related hospital readmission, and of these, one-third were readmitted ≤30 d of discharge. The economic burden of VTE-related or primary VTE hospital readmissions was substantial. Improvement in VTE prophylaxis across the inpatient/outpatient care continuum may reduce the clinical and economic burden of VTE and associated rehospitalizations in these patients.