title: 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.
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.
authors.affiliation: 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.
authors.forename: James
authors.initials: J
authors.lastname: Lewsey
authors.affiliation: Public Health, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. osaretinebueku@hotmail.co.uk.
authors.forename: Osaretin
authors.initials: O
authors.lastname: Ebueku
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK. pardeep@jhund.com.
authors.forename: Pardeep S
authors.initials: PS
authors.lastname: Jhund
authors.affiliation: Public Health, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. michelle.gillies@glasgow.ac.uk.
authors.forename: Michelle
authors.initials: M
authors.lastname: Gillies
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9 EB, UK. jim.chalmers@nhs.net.
authors.forename: Jim W T
authors.initials: JW
authors.lastname: Chalmers
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9 EB, UK. adam.d.redpath@hotmail.co.uk.
authors.forename: Adam
authors.initials: A
authors.lastname: Redpath
authors.affiliation: 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.
authors.forename: Andrew
authors.initials: A
authors.lastname: Briggs
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Gardiner Institute, Western Infirmary, Glasgow, G11 6NT, UK. matthew.walters@glasgow.ac.uk.
authors.forename: Matthew
authors.initials: M
authors.lastname: Walters
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Gardiner Institute, Western Infirmary, Glasgow, G11 6NT, UK. peter.langhorne@glasgow.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Langhorne
authors.affiliation: Public Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, L69 3GB, UK. capewell@liverpool.ac.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.affiliation: 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.
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
authors.affiliation: School of Medicine, University of Tasmania, 17 Liverpool Street, Hobart, Australia. kate.macintyre@utas.edu.au.
authors.forename: Kate
authors.initials: K
authors.lastname: MacIntyre
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D007239:Infections / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*