{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:11:50Z","timestamp":1791893510332,"version":"4.3.4"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Hospital readmission is a common but controversial quality measure increasingly used to influence hospital compensation in the US. The objective of this study was to evaluate the causes for 30-day hospital readmission following aneurysmal subarachnoid hemorrhage (SAH) to determine the appropriateness of this performance metric and to identify potential avenues for improved patient care.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively reviewed the medical records of all patients who received surgical orendovas-cular treatment for aneurysmal SAH at Barnes-Jewish Hospital between 2003 and 2013. Two senior faculty identified by consensus the primary medical\/surgical diagnosis associated with readmission as well as the underlying causes of rehospitalization.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Among 778 patients treated for aneurysmal SAH, 89 experienced a total of 97 readmission events, yielding a readmission rate of 11.4%. The median time from discharge to readmission was 9 days (interquartile range 3\u201317.5 days). Actual hydrocephalus or potential concern for hydrocephalus (e.g., headache) was the most frequent diagnosis (26\/97, 26.8%), followed by infections (e.g., wound infection [5\/97, 5.2%], urinary tract infection [3\/97, 3.1%], and pneumonia [3\/97, 3.1%]) and thromboembolic events (8\/97, 8.2%). In most cases (75\/97, 77.3%), we did not identify any treatment lapses contributing to readmission. The most common underlying causes for readmission were unavoidable development of SAH-related pathology (e.g., hydrocephalus; 36\/97, 37.1%) and complications related to neurological impairment and immobility (e.g., thromboembolic event despite high-dose chemoprophylaxis; 21\/97, 21.6%). The authors determined that 22\/97 (22.7%) of the readmissions were likely preventable with alternative management. In these cases, insufficient outpatient medical care (for example, for hyponatremia; 16\/97, 16.5%) was the most common shortcoming.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Most readmissions after aneurysmal SAH relate to late consequences of hemorrhage, such as hydrocephalus, or medical complications secondary to severe neurological injury. Although a minority of readmissions may potentially be avoided with closer medical follow-up in the transitional care environment, readmission after SAH is an insensitive and likely inappropriate hospital performance metric.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.2.jns142771","type":"journal-article","created":{"date-parts":[[2015,9,11]],"date-time":"2015-09-11T14:07:34Z","timestamp":1441980454000},"page":"743-749","source":"Crossref","is-referenced-by-count":36,"title":["Causes of 30-day readmission after aneurysmal subarachnoid hemorrhage"],"prefix":"10.3171","volume":"124","author":[{"given":"Jacob K.","family":"Greenberg","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad W.","family":"Washington","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ridhima","family":"Guniganti","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph G.","family":"Dacey","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin P.","family":"Derdeyn","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Neurology, and"},{"name":"Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Zipfel","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns142771","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"134","DOI":"10.3171\/2012.10.SPINE12559","article-title":"Pitfalls of calculating hospital readmission rates based on nonvalidated administrative data sets","volume":"18","author":"Amin","year":"2013"},{"key":"b2-jns142771","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3171\/2014.4.JNS13944","article-title":"Analysis of 30-day readmissions among neurosurgical patients: surgical complication avoidance as key to quality improvement","volume":"121","author":"Buchanan","year":"2014"},{"key":"b3-jns142771","series-title":"Hospital-Acquired Conditions","author":"Centers for Medicare & Medicaid Services"},{"key":"b4-jns142771","series-title":"Outcome measures. 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