Characteristics of Elderly People Readmitted to the Hospital during the First Year after Stroke

Abstract

Background and Purpose: Readmissions after acute stroke vary over time and with age and comorbidity. Knowledge of the reasons for readmissions and characteristics of readmitted patients is sparse. This 1-year prospective study examined whether readmissions were related to severity of the index stroke or to comorbidity and explored outcomes in readmitted patients with respect to daily life activities and health-related quality of life. Methods: The study included 216 elderly patients (aged ≧70 years) discharged to their homes or a nursing home after index stroke. The main outcomes were readmission rates and reported diagnoses, performance of daily life activities and health-related quality of life. Results: Nearly half (45%) of the patients were readmitted to the hospital after being discharged to their homes. One readmission was most common, and stroke-related diagnoses were most frequently reported as the reason for readmission. Different forms of heart disease were the next most common reason. The readmitted patients were significantly more dependent in daily life activities, and health-related quality of life was significantly lower among this group. Conclusions: Recurrent stroke and sequelae after stroke were major factors behind readmissions, followed by heart disease in elderly stroke patients. The readmitted patients were more dependent in daily life activities and reported a lower health-related quality of life compared with not readmitted patients.

Depression and Activities of Daily Living Predict Rehospitalization Within 6 Months of Discharge From Geriatric Rehabilitation.

“…These results are consistent with prior studies of geriatric rehabilitation patients (Sullivan, 1992), nonrehabilitation geriatric patients (Di Iorio et al, 1998), SCI patients (Eastwood et al, 1999; Ivie & DeVivo, 1994), and stroke patients (Claesson et al, 2002; Ottenbacher et al, 2001) in supporting the significant role of early ADL limitations in predicting subsequent rehospitalization. These findings are also unique in supporting the predictive value of early depressive symptoms in predicting rehospitalization in geriatric patients.…”

Depression and Activities of Daily Living Predict Rehospitalization Within 6 Months of Discharge From Geriatric Rehabilitation.

“…These results are consistent with prior studies of geriatric rehabilitation patients (Sullivan, 1992), nonrehabilitation geriatric patients (Di Iorio et al, 1998), SCI patients (Eastwood et al, 1999; Ivie & DeVivo, 1994), and stroke patients (Claesson et al, 2002; Ottenbacher et al, 2001) in supporting the significant role of early ADL limitations in predicting subsequent rehospitalization. These findings are also unique in supporting the predictive value of early depressive symptoms in predicting rehospitalization in geriatric patients.…”

Bouncing Back: Patterns and Predictors of Complicated Transitions 30 Days After Hospitalization for Acute Ischemic Stroke

“…Given the number and complexity of transitions acute stroke patients experience soon after hospitalization, the acute stroke population provides an ideal model for study of patient transitions and complicated transitions and for implementation of interventions designed to improve transitional care quality. These findings support those of previous studies documenting the high risk of readmission soon after acute stroke hospitalization and the frequent transitions acute stroke patients experience during their usual course of care 6,7 . Additionally, these data support the idea that complicated transitions soon after discharge are common in this population.…”

Causes and Predictors for Hospital Readmission after Ischemic Stroke

“…6,8,9 We found, however, no difference in length of index admission between the readmitted and not readmitted patients. Furthermore, the median length of index admission in our population was substantially lower than previously reported by other studies 7,8 and comparable to only 2 other studies which both reported length of index admission to be associated with readmission. 6,9 However, comparing early and late readmission showed that patients who were readmitted early had shorter length of index admission than patients readmitted late, even when adjusting for confounding factors including physical function and infection during index admission.…”

Depression and Activities of Daily Living Predict Rehospitalization Within 6 Months of Discharge From Geriatric Rehabilitation.

“…These results are consistent with prior studies of geriatric rehabilitation patients (Sullivan, 1992), nonrehabilitation geriatric patients (Di Iorio et al, 1998), SCI patients (Eastwood et al, 1999; Ivie & DeVivo, 1994), and stroke patients (Claesson et al, 2002; Ottenbacher et al, 2001) in supporting the significant role of early ADL limitations in predicting subsequent rehospitalization. These findings are also unique in supporting the predictive value of early depressive symptoms in predicting rehospitalization in geriatric patients.…”

Bouncing Back: Patterns and Predictors of Complicated Transitions 30 Days After Hospitalization for Acute Ischemic Stroke

“…Given the number and complexity of transitions acute stroke patients experience soon after hospitalization, the acute stroke population provides an ideal model for study of patient transitions and complicated transitions and for implementation of interventions designed to improve transitional care quality. These findings support those of previous studies documenting the high risk of readmission soon after acute stroke hospitalization and the frequent transitions acute stroke patients experience during their usual course of care 6,7 . Additionally, these data support the idea that complicated transitions soon after discharge are common in this population.…”

Causes and Predictors for Hospital Readmission after Ischemic Stroke

“…6,8,9 We found, however, no difference in length of index admission between the readmitted and not readmitted patients. Furthermore, the median length of index admission in our population was substantially lower than previously reported by other studies 7,8 and comparable to only 2 other studies which both reported length of index admission to be associated with readmission. 6,9 However, comparing early and late readmission showed that patients who were readmitted early had shorter length of index admission than patients readmitted late, even when adjusting for confounding factors including physical function and infection during index admission.…”

Depression and Activities of Daily Living Predict Rehospitalization Within 6 Months of Discharge From Geriatric Rehabilitation.

“…These results are consistent with prior studies of geriatric rehabilitation patients (Sullivan, 1992), nonrehabilitation geriatric patients (Di Iorio et al, 1998), SCI patients (Eastwood et al, 1999; Ivie & DeVivo, 1994), and stroke patients (Claesson et al, 2002; Ottenbacher et al, 2001) in supporting the significant role of early ADL limitations in predicting subsequent rehospitalization. These findings are also unique in supporting the predictive value of early depressive symptoms in predicting rehospitalization in geriatric patients.…”

Bouncing Back: Patterns and Predictors of Complicated Transitions 30 Days After Hospitalization for Acute Ischemic Stroke

“…Given the number and complexity of transitions acute stroke patients experience soon after hospitalization, the acute stroke population provides an ideal model for study of patient transitions and complicated transitions and for implementation of interventions designed to improve transitional care quality. These findings support those of previous studies documenting the high risk of readmission soon after acute stroke hospitalization and the frequent transitions acute stroke patients experience during their usual course of care 6,7 . Additionally, these data support the idea that complicated transitions soon after discharge are common in this population.…”

Causes and Predictors for Hospital Readmission after Ischemic Stroke

“…6,8,9 We found, however, no difference in length of index admission between the readmitted and not readmitted patients. Furthermore, the median length of index admission in our population was substantially lower than previously reported by other studies 7,8 and comparable to only 2 other studies which both reported length of index admission to be associated with readmission. 6,9 However, comparing early and late readmission showed that patients who were readmitted early had shorter length of index admission than patients readmitted late, even when adjusting for confounding factors including physical function and infection during index admission.…”