Predictors of 30-Day Hospital Readmission Following Ischemic and Hemorrhagic Stroke

• Published in: American journal of medical quality Vol. 30; no. 5; pp. 441 - 446
• Main Authors: Strowd, Roy E., Wise, Starla M., Umesi, U. Natalie, Bishop, Laura, Craig, Jeffrey, Lefkowitz, David, Reynolds, Patrick S., Tegeler, Charles, Arnan, Martinson, Duncan, Pamela W., Bushnell, Cheryl D.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-09-2015
• Subjects: Aged; Aged, 80 and over; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Brain Ischemia - therapy; Case-Control Studies; Female; Humans; Hyperlipidemias - diagnosis; Hyperlipidemias - epidemiology; Hyperlipidemias - therapy; Intracranial Hemorrhages - diagnosis; Intracranial Hemorrhages - epidemiology; Intracranial Hemorrhages - therapy; Male; Middle Aged; Patient Readmission - statistics & numerical data; Prognosis; Retrospective Studies; Severity of Illness Index; Stroke - diagnosis; Stroke - epidemiology; Stroke - therapy; hospital readmission; all cerebrovascular disease/stroke; case control studies; outcome research
• ISSN: 1062-8606; 1555-824X
• DOI: 10.1177/1062860614535838

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.