{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:44:04Z","timestamp":1768290244754,"version":"3.49.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,12,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Mortality and hospital readmission rates may reflect the quality of acute and postacute stroke care. Our aim was to investigate if, compared with usual care (UC), the COMPASS\u2010TC (Comprehensive Post\u2010Acute Stroke Services Transitional Care) intervention (INV) resulted in lower all\u2010cause and stroke\u2010specific readmissions and mortality among patients with minor stroke and transient ischemic attack discharged from 40 diverse North Carolina hospitals from 2016 to 2018.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Using Medicare fee\u2010for\u2010service claims linked with COMPASS cluster\u2010randomized trial data, we performed intention\u2010to\u2010treat analyses for 30\u2010day, 90\u2010day, and 1\u2010year unplanned all\u2010cause and stroke\u2010specific readmissions and all\u2010cause mortality between INV and UC groups, with 90\u2010day unplanned all\u2010cause readmissions as the primary outcome. Effect estimates were determined via mixed logistic or Cox proportional hazards regression models adjusted for age, sex, race, stroke severity, stroke diagnosis, and documented history of stroke. The final analysis cohort included 1069 INV and 1193 UC patients (median age 74\u00a0years, 80% White, 52% women, 40% with transient ischemic attack) with median length of hospital stay of 2\u00a0days. The risk of unplanned all\u2010cause readmission was similar between INV versus UC at 30 (9.9% versus 8.7%) and 90\u00a0days (19.9% versus 18.9%), respectively. No significant differences between randomization groups were seen in 1\u2010year all\u2010cause readmissions, stroke\u2010specific readmissions, or mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this pragmatic trial of patients with complex minor stroke\/transient ischemic attack, there was no difference in the risk of readmission or mortality with COMPASS\u2010TC relative to UC. Our study could not conclusively determine the reason for the lack of effectiveness of the INV.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02588664.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023394","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T09:06:39Z","timestamp":1635930399000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Hospital Readmissions and Mortality Among Fee\u2010for\u2010Service Medicare Patients With Minor Stroke or Transient Ischemic Attack: Findings From the COMPASS Cluster\u2010Randomized Pragmatic Trial"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3162-7610","authenticated-orcid":false,"given":"Cheryl D.","family":"Bushnell","sequence":"first","affiliation":[{"name":"Department of Neurology Wake Forest Baptist Health Winston\u2010Salem NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna M.","family":"Kucharska\u2010Newton","sequence":"additional","affiliation":[{"name":"Department of Epidemiology College of Public Health University of Kentucky Lexington KY"},{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara B.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill 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VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1300-353X","authenticated-orcid":false,"given":"Jacqueline R.","family":"Halladay","sequence":"additional","affiliation":[{"name":"Department of Family Medicine University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9708-8413","authenticated-orcid":false,"given":"Janet","family":"Prvu Bettger","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7480-0145","authenticated-orcid":false,"given":"Janet K.","family":"Freburger","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy School of Health and Rehabilitation Sciences University of Pittsburgh 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