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

Claesson, Lisbeth; Gosman‐Hedström, Gunilla; Lundgren-Lindquist, B; Fagerberg, Björn; Blomstrand, Christian

doi:10.1159/000065684

Cited by 20 publications

(22 citation statements)

References 36 publications

(55 reference statements)

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“…These readmission rates are higher than those of recent studies which reported 40% to 45% within 1 year [6,7], 26% to 44% within 6 months [8], and 18% within the first 3 months [7]. However, these studies included only elderly or ischemic stroke patients.…”

Section: Discussioncontrasting

confidence: 61%

Readmission after hospitalization for stroke in Taiwan: Results from a national sample

Tseng

Lin

2009

Journal of the Neurological Sciences

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Section: Discussioncontrasting

confidence: 61%

Readmission after hospitalization for stroke in Taiwan: Results from a national sample

Tseng

Lin

2009

Journal of the Neurological Sciences

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“…Our results are consistent with those from other studies on this topic, which suggested that between 31% and 49% of patients were readmitted within the year after the index stroke. [2][3][4][5][6][7][8][9] In addition, a cohort study showed that stroke patients had a 2-fold greater risk of readmission within 1 year compared with their matching nonstroke controls. 6 However, direct comparisons are made difficult by variations in case-mix between studies and the fact that previous works were limited by either the use of administrative databases with sometimes only scarce data on either the index stroke or the subsequent hospitalization, whereas other studies were hospital-based or considered readmissions to the same hospital only or both planned and unplanned hospitalizations.…”

Section: Discussionmentioning

confidence: 99%

“…This excess mortality in patients who needed to be readmitted was also found in a study that included stroke patients aged ≥70 years and also demonstrated that readmitted patients were more dependent in daily life activities and had a lower health-related quality of life. 2 Finally, readmission appeared to be also associated with higher medical costs. 8 Taken together, these results clearly indicate that reducing readmission should be a major goal for poststroke care.…”

Section: Strokementioning

confidence: 97%

“…One major issue is that the risk of all-cause readmission to hospital after stroke is high, ranging between 31% and 49% at 1 year according to various studies. [2][3][4][5][6][7][8][9] Readmission to hospital has a deleterious effect on the well-being of patients and leads to an increase in socioeconomic costs. 8,10 The better identification of patients at risk could therefore be useful so as to develop preventive strategies to reduce the number of emergency hospitalizations after stroke.…”

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confidence: 99%

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Hospitalization Within the First Year After Stroke

Lainay

Benzenine

Durier

et al. 2015

Stroke

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All patients with a first-ever stroke that occurred between January 1, 2009, and December 31, 2011, were prospectively identified among residents of the city of Dijon, France (151 543 inhabitants), from the Dijon Stroke Registry, a population-based study that was established in 1985.11 This registry complies with the defined criteria for conducting stroke incidence studies, 12,13 and its methodology has been extensively described elsewhere.11 Hence, to attempt to achieve complete case-ascertainment, hot and cold pursuit procedures based on multiple overlapping sources of information were used to identify fatal Background and Purpose-This population-based study aimed to identify unplanned hospitalization within the first year after stroke to determine factors associated with it and consequences on survival. Methods-All first-ever acute strokes occurring in Dijon, France, from 2009 to 2011, were prospectively collected from a population-based registry. Demographics and clinical data, including stroke severity measured by the National Institutes of Health Stroke Scale and disability after stroke, were recorded. For each patient, the first unplanned hospitalization that occurred within 1 year after stroke was retrieved by linking data with the national French Hospital Discharge Database. Predictors of hospitalization and survival at 1 year were identified using logistic regression models. Results-Among the 613 patients recorded, 94 (15.3%) were excluded because of early death. Of the 519 remaining patients, 167 (32.2%) were hospitalized at 1 year. Subsequent hospitalization led to in-hospital death for 16 (9.6%) patients. In multivariable analyses, only a history of hypertension and atrial fibrillation were associated with hospitalization. In stratified analyses, the National Institutes of Health Stroke Scale score was associated with a higher risk of hospitalization (odds ratio, 1.13; 95% confidence interval, 1.03-1.22; P=0.006), whereas only a trend was noted for disability (odds ratio, 2.26; 95% confidence interval, 0.82-6.22; P=0.113) in patients who returned home after the index stroke. Hospitalization was negatively associated with being alive at 1 year (odds ratio, 0.36; 95% confidence interval, 0.19-0.66; P<0.01). Conclusions-Stroke survivors are at high risk of hospitalization after the episode, and subsequent admission is associated with poor survival, thus highlighting the need for follow-up interventions after discharge to prevent readmission.

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“…stroke (41), heart and circulatory problems (42), has been found to increase readmission to hospital among older patients. One way of calculating multimorbidity is to count the number of diseases a person has without weighting or ranking them (43).…”

Section: Discussion Of Resultsmentioning

confidence: 99%

Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity

Mamhidir

Wimo

Kihlgren

2012

The Journal of nutrition, health and aging

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Objectives:The objective was to describe the extent to which nursing home patients had cognitive impairments and were diagnosed with dementia. Furthermore, to describe and compare multicomorbidity, health status and drug use in the three subgroups; dementia diagnosis/not referred, dementia diagnosis/referred and no dementia diagnosis/not referred to an emergency department (ED) over a one-year period. Methods: A crosssectional follow-up study was carried out in Sweden. RAI/MDS assessments were conducted on 719 patients in 24 nursing homes, of whom 209 were referred to EDs during a one-year period, accounting for 314 visits. This study involved an extensive examination of the population. Results: The 719 patients were reported to suffer from comprehensive cognitive impairments, which not accorded with the dementia diagnoses, they were significantly fewer. Cognitive decline or dementia diagnosis contributed to a significant decrease of referrals to EDs. Patients with dementia diagnosis/not referred had difficulties understanding others, as well as impaired vision and hearing. Patients with dementia diagnosis/referred usually understood messages. Low BMI, daily pain, multicomorbidity and high drug consumption occurred in all groups. Patients with no dementia diagnosis/not referred had significantly less multicomorbidity. Neuroleptica was significantly more prevalent among those with dementia diagnosis. Conclusion: Dementia remains undetected. Patients with cognitive decline and dementia are probably as sick as or even worse than others but may, due to low priority be undertreated or referrals avoided with the objective to provide good care in the setting. Observational studies are needed to identify what is done and could be done in referral situations. Key words:Nursing home, dementia, cognitive impairment, referrals, emergency department. 891The Journal of Nutrition, Health & Aging© Volume 16, Number 10, 2012 Received November 25, 2011 Accepted for publication January 19, 2012 07 MAMHIDIR/p/c_04 LORD_c 04/12/12 10:31 Page891 (17), the mean number of prescribed drugs was 10.3 per patient. The proportion of individuals prescribed psychotropic drugs was 80% in NHs and 85% in special care units for dementia. According to Olsson et al. (17), anticholinergic drugs were prescribed for approximately 20% of all NH patients and a high rate of psychotropic drug use (>=80%) was reported.Dementia is becoming a greater problem in health care globally (18), due to an increase in the number of people affected. In Sweden, the number of people suffering from dementia increased from 133, 000 to 148, 000 between 2000 and 2008 (14). Disorders such as dementia that cause cognitive impairment are common in long term institutional care. Mamhidir et al. (19) found that cognitive impairment was present in 67% of NH patients and Nordberg et al. (20) reported 62%. Such patients often exhibit symptoms that are difficult to interpret. Although they have the same illnesses as younger patients, their symptoms differ as they...

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

Cited by 20 publications

References 36 publications

Readmission after hospitalization for stroke in Taiwan: Results from a national sample

Readmission after hospitalization for stroke in Taiwan: Results from a national sample

Hospitalization Within the First Year After Stroke

Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity

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