BACKGROUND AND PURPOSE Venous thromboembolism (VTE) is a life-threatening complication of stroke. We evaluated nationwide rates and risk factors for hospital readmissions with VTE after an intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS) hospitalization. METHODS Using the Healthcare Cost and Utilization Project (HCUP) Nationwide Readmission Database, we included patients with a principal discharge diagnosis of ICH or AIS from 2016 to 2019. Patients who had VTE diagnosis or history of VTE during the index admission were excluded. We performed Cox regression models to determine factors associated with VTE readmission, compared rates between AIS and ICH and developed post-stroke VTE risk score. We estimated VTE readmission rates per day over a 90-day time window post-discharge using linear splines. RESULTS Of the total 1,459,865 patients with stroke, readmission with VTE as the principal diagnosis within 90 days occurred in 0.26% (3,407/1,330,584) AIS and 0.65% (843/129,281) ICH patients. The rate of VTE readmission decreased within first 4-6 weeks (P<0.001). In AIS, cancer, obesity, higher National Institutes of Health Stroke Scale (NIHSS) score, longer hospital stay, home or rehabilitation disposition, and absence of atrial fibrillation were associated with VTE readmission. In ICH, longer hospital stay and rehabilitation disposition were associated with VTE readmission. The VTE rate was higher in ICH compared to AIS (adjusted hazard ratio 2.86, 95% confidence interval 1.93-4.25, P<0.001). CONCLUSIONS After stroke, VTE readmission risk is highest within the first 4-6 weeks and nearly three-fold higher after ICH vs. AIS. VTE risk is linked to decreased mobility and hypercoagulability. Studies are needed to test short-term VTE prophylaxis beyond hospitalization in high-risk patients.

中文翻译：

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缺血性中风和脑出血后静脉血栓栓塞再入院率的趋势。

背景和目的 静脉血栓栓塞症 (VTE) 是一种危及生命的卒中并发症。我们评估了脑出血 (ICH) 或急性缺血性卒中 (AIS) 住院后因 VTE 再入院的全国率和危险因素。方法 使用医疗保健成本和利用项目 (HCUP) 全国再入院数据库，我们纳入了 2016 年至 2019 年主要出院诊断为 ICH 或 AIS 的患者。排除了入院期间诊断为 VTE 或有 VTE 病史的患者。我们执行了 Cox 回归模型以确定与 VTE 再入院相关的因素，比较了 AIS 和 ICH 之间的发生率，并开发了卒中后 VTE 风险评分。我们使用线性样条估计出院后 90 天时间窗口内每天的 VTE 再入院率。结果 在总共 1,459 个中，在 865 名卒中患者中，90 天内以 VTE 为主要诊断的再入院发生在 0.26% (3,407/1,330,584) AIS 和 0.65% (843/129,281) ICH 患者中。VTE 再入院率在前 4-6 周内下降 (P<0.001)。在 AIS 中，癌症、肥胖、较高的美国国立卫生研究院卒中量表 (NIHSS) 评分、较长的住院时间、家庭或康复处置以及没有心房颤动与 VTE 再入院相关。在 ICH 中，较长的住院时间和康复处置与 VTE 再入院相关。与 AIS 相比，ICH 的 VTE 发生率更高（调整后的风险比 2.86，95% 置信区间 1.93-4.25，P<0.001）。结论 卒中后，VTE 再入院风险在前 4-6 周内最高，ICH 与 AIS 相比高近三倍。VTE 风险与活动能力下降和高凝状态有关。需要研究来测试高危患者住院后的短期 VTE 预防。