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BMC Neurol. 2015 Jan 16;15:3. doi: 10.1186/s12883-014-0257-1.

Temporal trends and risk factors for readmission for infections, gastrointestinal and immobility complications after an incident hospitalisation for stroke in Scotland between 1997 and 2005.

Author information

1
Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. jim.lewsey@glasgow.ac.uk.
2
Public Health, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. osaretinebueku@hotmail.co.uk.
3
BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK. pardeep@jhund.com.
4
Public Health, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. michelle.gillies@glasgow.ac.uk.
5
Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9 EB, UK. jim.chalmers@nhs.net.
6
Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9 EB, UK. adam.d.redpath@hotmail.co.uk.
7
Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. andrew.briggs@glasgow.ac.uk.
8
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Gardiner Institute, Western Infirmary, Glasgow, G11 6NT, UK. matthew.walters@glasgow.ac.uk.
9
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Gardiner Institute, Western Infirmary, Glasgow, G11 6NT, UK. peter.langhorne@glasgow.ac.uk.
10
Public Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, L69 3GB, UK. capewell@liverpool.ac.uk.
11
BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK. john.mcmurray@glasgow.ac.uk.
12
School of Medicine, University of Tasmania, 17 Liverpool Street, Hobart, Australia. kate.macintyre@utas.edu.au.

Abstract

BACKGROUND:

Improvements in stroke management have led to increases in the numbers of stroke survivors over the last decade and there has been a corresponding increase of hospital readmissions after an initial stroke hospitalisation. The aim of this study was to examine the one year risk of having a readmission due to infective, gastrointestinal or immobility (IGI) complications and to identify temporal trends and any risk factors.

METHODS:

Using a cohort of first hospitalised for stroke patients who were discharged alive, time to first event (readmission for IGI complications or death) within 1 year was analysed in a competing risks framework using cumulative incidence methods. Regression on the cumulative incidence function was used to model the risks of having an outcome using the covariates age, sex, socioeconomic status, comorbidity, discharge destination and length of hospital stay.

RESULTS:

There were a total of 51,182 patients discharged alive after an incident stroke hospitalisation in Scotland between 1997-2005, and 7,747 (15.1%) were readmitted for IGI complications within a year of the discharge. Comparing incident stroke hospitalisations in 2005 with 1997, the adjusted risk of IGI readmission did not increase (HR = 1.00 95% CI (0.90, 1.11). However, there was a higher risk of IGI readmission with increasing levels of deprivation (most deprived fifth vs. least deprived fifth HR = 1.16 (1.08, 1.26).

CONCLUSIONS:

Approximately 15 in 100 patients discharged alive after an incident hospitalisation for stroke in Scotland between 1997 and 2005 went on to have an IGI readmission within one year. The proportion of readmissions did not change over the study period but those living in deprived areas had an increased risk.

PMID:
25591718
PMCID:
PMC4320501
DOI:
10.1186/s12883-014-0257-1
[Indexed for MEDLINE]
Free PMC Article

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