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Am J Med Qual. 2015 Sep-Oct;30(5):441-6. doi: 10.1177/1062860614535838. Epub 2014 Jun 11.

Predictors of 30-day hospital readmission following ischemic and hemorrhagic stroke.

Author information

1
Wake Forest School of Medicine, Winston Salem, NC.
2
Mercy Hospital, Oklahoma City, OK.
3
Wake Forest School of Medicine, Winston Salem, NC cbushnel@wakehealth.edu.

Abstract

Stroke patients have a high rate of 30-day readmission. Understanding the characteristics of patients at high risk of readmission is critical. A retrospective case-control study was designed to determine factors associated with 30-day readmission after stroke. A total of 79 cases with acute ischemic or hemorrhagic strokes readmitted to the same hospital within 30 days were compared with 86 frequency-matched controls. Readmitted patients were more likely to have had ≥2 hospitalizations in the year prior to stroke (21.5% vs 2.3% in controls, P < .001), and in the multivariate model, admission National Institutes of Health Stroke Score (NIHSS; odds ratio [OR] = 1.072; 95% confidence interval [CI] = 1.021-1.126 per 1 point increase; P = .005), prior hospitalizations (OR = 2.205; 95% CI = 1.426-3.412 per admission; P < .001), and absence of hyperlipidemia (OR = 0.444; 95% CI = 0.221-0.894; P = .023) were independently associated with readmission. The research team concludes that admission NIHSS and frequent prior hospitalizations are associated with 30-day readmission after stroke. If validated, these characteristics identify high-risk patients and focus efforts to reduce readmission.

KEYWORDS:

all cerebrovascular disease/stroke; case control studies; hospital readmission; outcome research

PMID:
24919597
DOI:
10.1177/1062860614535838
[Indexed for MEDLINE]

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