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

Tseng, Mei‐Chiun; Lin, Hongbo

doi:10.1016/j.jns.2009.04.009

Cited by 55 publications

(66 citation statements)

References 19 publications

(22 reference statements)

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“…A previous study suggested that LOS could be used as a crude proxy for stroke severity, particularly when patients who died during index hospitalization or immediately after discharge were excluded. 18 Although the extent to which LOS can serve as a proxy of stroke severity remains an open question, we believe that LOS as an indicator of stroke severity is reasonable and reflects the readmission rate over the long term. The data in this study indicate that the patterns of care at initial stroke in Taiwan are almost concordant with evidence-based practice guidelines; in particular, the rate of antiplatelet agent use at the initial stroke was high (i.e.…”

Section: Discussionmentioning

confidence: 90%

Predictors for readmission of acute ischemic stroke in Taiwan

Yang

Chung

2011

Journal of the Formosan Medical Association

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Section: Discussionmentioning

confidence: 90%

Predictors for readmission of acute ischemic stroke in Taiwan

Yang

Chung

2011

Journal of the Formosan Medical Association

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“…3,18 In univariate and multivariate analyses without stratification, stroke severity, either initial severity measured by the NIHSS score or residual disability measured using the mRS, was not an independent factor associated with subsequent hospitalization either. Only 2 studies considered stroke severity in their multivariable analyses.…”

Section: Discussionmentioning

confidence: 94%

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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“…As has been suggested previously, the length of stay may be a representation of disease severity with greater disease severity associated with longer index hospitalizations. 6 Previous studies of patients with stroke have also identified a lower risk for 30-day readmission among patients discharged from neurology or neurosurgical services. 6,7 While specialty of discharge provider was not a predictor of 30-day readmission in our multivariable analysis, we did identify a trend toward lower readmission rates for patients with stroke discharged from neurology services compared with other nonsurgical specialties.…”

Section: Discussionmentioning

confidence: 99%

Avoidable 30-Day Readmissions Among Patients With Stroke and Other Cerebrovascular Disease

Nahab

Takesaka

Mailyan

et al. 2011

The Neurohospitalist

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Background: There are limited data on factors associated with 30-day readmissions and the frequency of avoidable readmissions among patients with stroke and other cerebrovascular disease. Methods: University HealthSystem Consortium (UHC) database records were used to identify patients discharged with a diagnosis of stroke or other cerebrovascular disease at a university hospital from January 1, 2007 to December 31, 2009 and readmitted within 30 days to the index hospital. Logistic regression models were used to identify patient and clinical characteristics associated with 30-day readmission. Two neurologists performed chart reviews on readmissions to identify avoidable cases. Results: Of 2706 patients discharged during the study period, 174 patients had 178 readmissions (6.4%) within 30 days. The only factor associated with 30-day readmission was the index length of stay >10 days (vs <5 days; odds ratio [OR] 2.3, 95% CI [1.4, 3.7]). Of 174 patients readmitted within 30 days (median time to readmission 10 days), 92 (53%) were considered avoidable readmissions including 38 (41%) readmitted for elective procedures within 30 days of discharge, 27 (29%) readmitted after inadequate outpatient care coordination, 15 (16%) readmitted after incomplete initial evaluations, 8 (9%) readmitted due to delayed palliative care consultation, and 4 (4%) readmitted after being discharged with inadequate discharge instructions. Only 5% of the readmitted patients had outpatient follow-up recommended within 1 week. Conclusions: More than half of the 30-day readmissions were considered avoidable. Coordinated timing of elective procedures and earlier outpatient follow-up may prevent the majority of avoidable readmissions among patients with stroke and other cerebrovascular disease.

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

Cited by 55 publications

References 19 publications

Predictors for readmission of acute ischemic stroke in Taiwan

Predictors for readmission of acute ischemic stroke in Taiwan

Hospitalization Within the First Year After Stroke

Avoidable 30-Day Readmissions Among Patients With Stroke and Other Cerebrovascular Disease

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