Readmission patterns and 6-month outcomes in patients with spontaneous intracerebral hematoma: a single centre retrospective analysis in Ghana.

Abstract

Hospital readmissions following spontaneous intracerebral hemorrhage (sICH) are a significant concern in Ghana. The paper explores readmission rates and influencing factors. Adult patients with sICH between 2021 and 2023 were reviewed to evaluate readmission rates and associated factors. Statistical analyses were performed using Wilcoxon rank sum and chi-square tests comparing non-readmitted and readmitted groups. The study included 102 patients, of which 82.4% (84) were not readmitted and 17.6% (18) were re-admitted. The median age of patients in the non-readmitted group was 50 years (Interquartile range [IQR]: 44-60) vs. 60.5 years (IQR: 50-71.5). Regarding gender, 61 patients (72.6%) in the non-readmitted group were male, while the readmitted group had an equal number of males and females (9 each, 50.0%). Hypertension was the most prevalent comorbidity in both groups, observed in 71 patients (85.5%) vs. 15 patients (83.3%). Most patients were managed conservatively, with 88.1% of non-readmitted patients and 77.8% of readmitted patients receiving conservative treatment (p = 0.265). The median hospital length of stay was 8.5 days (IQR: 4-14.8) vs. 5 days (IQR: 3-11, p = 0.094). The median modified rankin scale (mRS) score at 1-month post-discharge was 2.0 (IQR: 0.5-4) for the non-readmitted group and 3.5 (IQR: 3-4) for the readmitted group (p = 0.225). At 6 months post-discharge, the median mRS score was 1 (IQR: 0-3) in the non-readmitted group and 3.5 (IQR: 3-4) in the readmitted group (p = 0.072). Readmitted patients had a higher median age, greater prevalence of diabetes, and worse functional outcomes at 1- and 6-month follow-ups. These findings highlight the need for comprehensive discharge planning and post-discharge support for sICH patients, particularly those with diabetes and higher mRS scores. Tailored interventions and follow-up protocols can potentially reduce readmission rates and improve outcomes, warranting further research in this area.