title: Predictors of 30-day hospital readmission following ischemic and hemorrhagic stroke.
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.
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Roy E
authors.initials: RE
authors.lastname: Strowd
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Starla M
authors.initials: SM
authors.lastname: Wise
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: U Natalie
authors.initials: UN
authors.lastname: Umesi
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Laura
authors.initials: L
authors.lastname: Bishop
authors.affiliation: Mercy Hospital, Oklahoma City, OK.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Craig
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: David
authors.initials: D
authors.lastname: Lefkowitz
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Reynolds
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Charles
authors.initials: C
authors.lastname: Tegeler
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Martinson
authors.initials: M
authors.lastname: Arnan
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Pamela W
authors.initials: PW
authors.lastname: Duncan
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC cbushnel@wakehealth.edu.
authors.forename: Cheryl D
authors.initials: CD
authors.lastname: Bushnell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*
keywords: all cerebrovascular disease/stroke; case control studies; hospital readmission; outcome research