title: Bouncing-back: rehospitalization in patients with complicated transitions in the first thirty days after hospital discharge for acute stroke.
abstract: BACKGROUND
  "Bounce-backs" (movements from a less intensive to a more intensive care setting) soon after hospital discharge are common, but reasons for bouncing-back remain unknown.
  
  
  OBJECTIVE
  To examine how the primary diagnosis for first rehospitalization relates to thirty-day bounce-back number and initial discharge destination in acute stroke.
  
  
  METHODS
  Administrative data from 5,250 Medicare beneficiaries > or = 65 years discharged with acute ischemic stroke in 1998-2000 to a rehabilitation center, skilled nursing facility or home with home health care and with at least one thirty day rehospitalization.
  
  
  METHODS
  Probability of thirty-day bounce-back was calculated using multivariate models.
  
  
  RESULTS
  Infections and aspiration pneumonitis were the most common reasons for rehospitalization, regardless of initial discharge site.
  
  
  CONCLUSIONS
  Efforts addressing aspirations and infections, the preventable complications of immobility, will be critical in decreasing acute stroke bounce-backs.
authors.affiliation: Department of Population Health Sciences, Geriatrics Division, University of Wisconsin School of Medicine and Public Health, Wadison, WI, USA. ajk@medicine.wisc.edu
authors.forename: Amy J H
authors.initials: AJ
authors.lastname: Kind
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Smith
authors.forename: Nancy
authors.initials: N
authors.lastname: Pandhi
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Frytak
authors.forename: Michael D
authors.initials: MD
authors.lastname: Finch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008329:Managed Care Programs; D010351:Patient Discharge; D010359:Patient Readmission / Q000639:trends*; D020521:Stroke / Q000150:complications* / Q000401:mortality; D014481:United States / Q000453:epidemiology