http://ajm.sagepub.com/content/early/2014/06/10/1062860614535838.abstract
- Roy E. Strowd, MD1
- Starla M. Wise, DO1
- U. Natalie Umesi, BS1
- Laura Bishop, DO1
- Jeffrey Craig, MD2
- David Lefkowitz, MD1
- Patrick S. Reynolds, MD1
- Charles Tegeler, MD1
- Martinson Arnan, MD1
- Pamela W. Duncan, PhD1
- Cheryl D. Bushnell, MD, MHS1
- Cheryl D. Bushnell, MD, MHS, Wake Forest Baptist Stroke Center, Department of Neurology, Medical Center Blvd, Wake Forest School of Medicine, Winston-Salem, NC 27157. Email: cbushnel@wakehealth.edu
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.
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