title: Complications following incident stroke resulting in readmissions: an analysis of data from three Scottish health surveys.
abstract: OBJECTIVE
  Stroke is widely recognized as the major contributor to morbidity and mortality in the United Kingdom. We analyzed the data obtained from the three consecutive Scottish Health Surveys and the Scottish Morbidity records, with the aim of identifying risk factors for, and timing of, common poststroke complications.
  
  
  METHODS
  There were 19434 individuals sampled during three Scottish Health Surveys in 1995, 1998, and 2001. For these individuals their morbidity and mortality outcomes were obtained in 2007. Incident stroke prevalence, risk factors for a range of poststroke complications, and average times until such complications in the sample were established.
  
  
  RESULTS
  Of the total of 168 incident stroke admissions (0·86% of the survey), 16·1% people died during incident stroke hospitalization. Of the remaining 141 stroke survivors, 75·2% were rehospitalized at least once. The most frequent reason for readmission after stroke was a cardiovascular complication (28·6%), median time until event 1412 days, followed by infection (17·3%, median 1591 days). The risk of cardiovascular readmission was higher in those with 'poor' self-assessed health (odds ratio 7·70; 95% confidence interval 1·64-43·27), smokers (odds ratio 4·24; 95% confidence interval 1·11-21·59), and doubled with every five years increase in age (odds ratio 1·97; 95% confidence interval 1·46-2·65). 'Poor' self-assessed health increased chance of readmission for infection (odds ratio 14·11; 95% confidence interval 2·27-276·56).
  
  
  CONCLUSIONS
  Cardiovascular events and infections are the most frequent poststroke complications resulting in readmissions. The time period until event provides a possibility to focus monitoring on those people at risk of readmission and introduce preventative measures, thereby reducing readmission-associated costs.
authors.affiliation: Department of Anesthesiology, Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Ponomarev
authors.affiliation: School of Mathematics and Statistics, University of Glasgow, Glasgow, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Miller
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Govan
authors.affiliation: Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Haig
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
authors.forename: Olivia
authors.initials: O
authors.lastname: Wu
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Langhorne
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D007239:Infections / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D020521:Stroke / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D016019:Survival Analysis
keywords: Scotland; cardiovascular; infection; models; readmission; stroke