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

And if our doctors would stop all the death and damage going on the first week because of the neuronal cascade of death I bet this factor would be significantly reduced for stroke. But I can guarantee that nothing will be done, we seem to have no one willing to try anything outside the current failure of standard of care. F*cking hey.
http://ajm.sagepub.com/content/early/2014/06/10/1062860614535838.abstract

1. Roy E. Strowd, MD1
2. Starla M. Wise, DO1
3. U. Natalie Umesi, BS1
4. Laura Bishop, DO1
5. Jeffrey Craig, MD2
6. David Lefkowitz, MD1
7. Patrick S. Reynolds, MD1
8. Charles Tegeler, MD1
9. Martinson Arnan, MD1
10. Pamela W. Duncan, PhD1
11. Cheryl D. Bushnell, MD, MHS1

1. ¹Wake Forest School of Medicine, Winston Salem, NC
2. ²Mercy Hospital, Oklahoma City, OK

1. 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.