{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T21:36:59Z","timestamp":1793914619084,"version":"4.8.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Studies evaluating health system factors associated with major adverse cardiovascular events (MACE) among intracerebral hemorrhage (ICH) survivors are lacking. We evaluate differences in MACE incidence across postacute ICH care settings\u2014inpatient rehabilitation facilities (IRF), home, or skilled nursing facilities (SNF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Using data from Florida, New York, Maryland, Washington, and Georgia, we identified adult ICH survivors discharged to home, IRF, or SNF (April 2016\u2013December 2018). Multivariable logistic models, adjusted for sociodemographic factors, treatment intensity, comorbidities, and frailty, estimated adjusted odds ratios (aORs) and 95% CI for the association between discharge disposition (IRF versus home; IRF versus SNF) and MACE (a composite of acute stroke, acute myocardial infarction, systemic embolism, and vascular death), recurrent ICH, acute ischemic stroke, acute myocardial infarction, vascular death, and all-cause mortality within 1 year. Cardiovascular outcomes were ascertained using\n                      <jats:italic toggle=\"yes\">International Classification of Diseases, Tenth Revision<\/jats:italic>\n                      codes. We assessed interaction between age and discharge disposition, performing stratified analyses for patients &lt;65 and \u226565 years when the interaction was significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 58\u2005591 patients with ICH (mean age [SD], 68.1 [16.0] years; 47.1% female), 17\u2005647 ICH survivors discharged home (46.4%), to IRF (25.5%), or to SNF (28.1%) were included. Within 1 year, 1302 (7.4%) patients experienced MACE, with rates for recurrent ICH, acute ischemic stroke, acute myocardial infarction, vascular death, and mortality at 2.5%, 3.2%, 0.6%, 1.3%, and 3.5%, respectively. In fully adjusted models, patients discharged to IRF had significantly lower odds of MACE (versus home: aOR, 0.84 [CI, 0.71\u20130.98]; versus SNF: aOR, 0.79 [CI, 0.67\u20130.93]), with a significant discharge disposition-age interaction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.047). In stratified analysis, IRF discharge (versus home) was only significantly associated with MACE in patients aged &lt;65 years (aOR, 0.70 [CI, 0.54\u20130.92]), not in those aged \u226565 years (aOR, 0.94 [CI, 0.77\u20131.15]). Patients discharged to IRF had significantly lower odds of recurrent ICH (versus SNF: aOR, 0.60 [CI, 0.45\u20130.80]), vascular death (versus SNF: aOR, 0.70 [CI, 0.49\u20130.99]), and all-cause mortality (versus SNF: aOR, 0.63 [CI, 0.50\u20130.79]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>IRF care (versus SNF and home) was associated with lower odds of MACE. Further research is needed to determine specific components of IRF care contributing to better outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.050620","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T05:00:15Z","timestamp":1750914015000},"page":"2658-2668","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Postacute Discharge Destination and Major Adverse Cardiovascular Events Among Patients With Intracerebral Hemorrhage"],"prefix":"10.1161","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1584-8114","authenticated-orcid":true,"given":"Abdulaziz T.","family":"Bako","sequence":"first","affiliation":[{"name":"Center for Health Outcomes and Informatics Research in Rehabilitation, The Institute for Rehabilitation and Research (TIRR) Memorial Hermann, Houston, TX (A.T.B., C.C.H., R.A., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7884-4172","authenticated-orcid":true,"given":"Thomas B.H.","family":"Potter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Houston Methodist, TX (T.B.H.P., A.P.P., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8782-8024","authenticated-orcid":true,"given":"Alan P.","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Houston Methodist, TX (T.B.H.P., A.P.P., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4817-554X","authenticated-orcid":true,"given":"Chih-Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, University of Texas Medical Branch, Galveston (C.-Y.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0416-2712","authenticated-orcid":true,"given":"Catherine Cooper","family":"Hay","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes and Informatics Research in Rehabilitation, The Institute for Rehabilitation and Research (TIRR) Memorial Hermann, Houston, TX (A.T.B., C.C.H., R.A., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8019-6343","authenticated-orcid":true,"given":"Mathew J.","family":"Reeves","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Michigan State University, East Lansing (M.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda","family":"Abott","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes and Informatics Research in Rehabilitation, The Institute for Rehabilitation and Research (TIRR) Memorial Hermann, Houston, TX (A.T.B., C.C.H., R.A., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3464-2111","authenticated-orcid":true,"given":"Farhaan S.","family":"Vahidy","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes and Informatics Research in Rehabilitation, The Institute for Rehabilitation and Research (TIRR) Memorial Hermann, Houston, TX (A.T.B., C.C.H., R.A., F.S.V.)."},{"name":"Department of Neurosurgery, Houston Methodist, TX (T.B.H.P., A.P.P., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16405-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-306476"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.027403"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-020-00950-2"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.036884"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.5882"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.039819"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000069"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000098"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107109"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2017.09.005"},{"key":"e_1_3_3_14_2","first-page":"615","article-title":"The optimal outcomes of post-hospital care under Medicare.","volume":"35","author":"Kane RL","year":"2000","unstructured":"Kane RL, Chen Q, Finch M, Blewett L, Burns R, Moskowitz M. 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