%0 Journal Article
%T The effect of 30-day adequate transitions of acute stroke care on 90-day readmission or death.
%A Johnson KH
%A Gardener H
%A Gutierrez C
%A Marulanda E
%A Campo-Bustillo I
%A Gordon Perue G
%A Brown SC
%A Ying H
%A Zhou L
%A Bishop L
%A Veledar E
%A Fakoori F
%A Asdaghi N
%A Romano JG
%A Rundek T
%A  
%J J Stroke Cerebrovasc Dis
%V 33
%N 9
%D 2024 Sep 30
%M 38955245
%F 2.677
%R 10.1016/j.jstrokecerebrovasdis.2024.107842
%X <B>OBJECTIVE: </B>We explore patient-reported behaviors and activities within 30-days post-stroke hospitalization and their role in reducing death or readmissions within 90-days post-stroke.<BR><B>METHODS: </B>We constructed the adequate transitions of care (ATOC) composite score, measuring patient-reported participation in eligible behaviors and activities (diet modification, weekly exercise, follow-up medical appointment attendance, medication adherence, therapy use, and toxic habit cessation) within 30 days post-stroke hospital discharge. We analyzed ATOC scores in ischemic and intracerebral hemorrhage stroke patients discharged from the hospital to home or rehabilitation facilities and enrolled in the NIH-funded Transitions of Care Stroke Disparities Study (TCSD-S). We utilized Cox regression analysis, with the progressive adjustment for sociodemographic variables, social determinants of health, and stroke risk factors, to determine the associations between ATOC score within 30-days and death or readmission within 90-days post-stroke.<BR><B>RESULTS: </B>In our sample of 1239 stroke patients (mean age 64 +/- 14, 58 % male, 22 % Hispanic, 22 % Black, 52 % White, 76 % discharged home), 13 % experienced a readmission or death within 90 days (3 deaths, 160 readmissions, 3 readmissions with subsequent death). Seventy percent of participants accomplished a ≥75 % ATOC score. A 25 % increase in ATOC was associated with a respective 20 % (95 % CI 3-33 %) reduced risk of death or readmission within 90-days.<BR><B>CONCLUSIONS: </B>ATOC represents modifiable behaviors and activities within 30-days post-stroke that are associated with reduced risk of death or readmission within 90-days post-stroke. The ATOC score should be validated in other populations, but it can serve as a tool for improving transitions of stroke care initiatives and interventions.