Patient and Hospital Factors associated with 30-Day Unplanned Readmission in Patients with Stroke

Lee, Sang Ah; Park, Sohee; Shin, Jae Yong; Ju, Yeong Jun; Choi, Young Sik; Lee, Hoo Yeon

doi:10.1136/jim-2018-000748

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…Contributing factors to readmissions include falls, urinary tract infection and recurrence of stroke (Abreu et al, 2020;Kilkenny et al, 2020). These factors are preventable via person-centred discharge planning and follow-up support after discharge (Abreu et al, 2020;Lee et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Enablers and barriers in hospital‐to‐home transitional care for stroke survivors and caregivers: A systematic review

Chen

Xiao

Chamberlain

et al. 2021

Journal of Clinical Nursing

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Aims and objectives:To synthesise qualitative research evidence on the experience of stroke survivors and informal caregivers in hospital-to-home transitional care.Background: Due to a shortened hospital stay, stroke survivors/caregivers must take over complex care on discharge from hospital to home. Gaps in the literature warrant a meta-synthesis of qualitative studies on perceived enablers and barriers during this crucial period. Design:A systematic review and meta-synthesis. Methods: A review was guided by Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist where six databases were searched from April to June 2020 including CINAHL Plus, MEDLINE, PsycINFO, Scopus, Web of Science and ProQuest and ProQuest Dissertations and Theses. There was no date limit to the search. Selected studies were critically appraised. A thematic synthesis approach was applied.Results: The synthesis of 29 studies identified three major findings. First, partnerships with stroke survivors/caregivers empower discharge preparation, foster competence to navigate health and social care systems and activate self-management capabilities.Second, gaps in discharge planning and the lack of timely postdischarge support contribute to unmet care needs for stroke survivors/caregivers and affect their ability to cope with poststroke changes. Third, stroke survivors/caregivers expect integrated transitional care that promotes shared decision-making and enables long-term selfmanagement at home. Conclusions:Hospital-to-home transition is a challenging period in the trajectory of poststroke rehabilitation and recovery. Further research is required to deepen understandings of all stakeholders' views and address unmet needs during transitional care.Relevance to clinical practice: Protocols and clinical guidelines relating to discharge planning and transitional care need to be reviewed to ensure partnership approach with survivors/caregivers in the design and delivery of individualised transitional care.Stroke nurses are in a unique position to lead timely support for survivors/caregivers and to bridge service gaps in hospital-to-home transitional care. | 2787 CHEN Et al.

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Section: Introductionmentioning

confidence: 99%

Enablers and barriers in hospital‐to‐home transitional care for stroke survivors and caregivers: A systematic review

Chen

Xiao

Chamberlain

et al. 2021

Journal of Clinical Nursing

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“…There was no definite answer in our current analysis. In terms of length of hospital stay, some Korean and American studies (7,12,33,36) suggested that the length of hospital stay affects the 30-day readmission in patients with ischemic stroke, which was corroborated by the results of a few prospective cohort studies (32,38). Conversely, other studies from Norway (4), Australia (35), and China (28) reported opposing results.…”

Section: Discussionmentioning

confidence: 97%

“…Length of hospital stay and age have been explored in many studies, but the type of data reported varied widely across studies. (4,11,30,34,35) reported the medians and quartiles, while Crispo et al and Lee et al (12,36) performed subgroup comparisons. The same was true for age, with means and SD (4,5,7,17,18,22,28,30,34), medians and quartiles (11,35), and subgroup comparisons (12,18,29,33,36) being reported in different articles, which proved problematic in allowing us to obtain accurate quantitative results via meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…(4,11,30,34,35) reported the medians and quartiles, while Crispo et al and Lee et al (12,36) performed subgroup comparisons. The same was true for age, with means and SD (4,5,7,17,18,22,28,30,34), medians and quartiles (11,35), and subgroup comparisons (12,18,29,33,36) being reported in different articles, which proved problematic in allowing us to obtain accurate quantitative results via meta-analysis. We believe that advanced age is largely a risk factor for 30-day readmission, while the length of hospital stay is still a controversial factor.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for 30-day readmission in patients with ischemic stroke: a systematic review and meta-analysis

Deng¹,

Wu²,

Hu³

et al. 2021

Ann Palliat Med

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Background: The aim of this study was to identify risk factors for 30-day readmission in ischemic stroke survivors, with an attempt to improve post-discharge care and lower the 30-day readmission rate.Methods: Seven databases were searched from inception to April 30, 2021. Retrospective or prospective observational studies and interventional studies focusing on 30-day readmission risk factors in patients with ischemic stroke were included. Two authors independently screened the literature and evaluated the quality of the studies using the Newcastle-Ottawa scale (NOS). The pooled effect size was estimated using the odds ratio (OR), and the corresponding 95% confidence interval (CI) was calculated. The Cochrane Q (χ 2 ) and I 2 tests were used to assess heterogeneity among studies, and each risk factor was tested for its robustness using fixed-or random-effects models.Results: A total of 17 retrospective observational studies from the United States (n=10), China (n=2), Republic of Korea (n=2), Norway (n=2), and Australia (n=1), comprising a total of 1,829,964 patients, were included. The 30-day readmission rates of ischemic stroke survivors ranged from 1.41% to 27.64%, with a

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“…was reported in Korea and Taiwan respectively [11,18]. On the other hand, 29% were readmitted within 31 days for stroke-related conditions in China [19].…”

Section: Plos Onementioning

confidence: 99%

Risk of 28-day readmissions among stroke patients in Malaysia (2008–2015): Trends, causes and its associated factors

et al. 2021

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Background and objectives Risk of readmissions is an important quality indicator for stroke care. Such information is limited among low- and middle-income countries. We assessed the trends for 28-day readmissions after a stroke in Malaysia from 2008 to 2015 and evaluated the causes and factors associated with readmissions in 2015. Methods Using the national hospital admission records database, we included all stroke patients who were discharged alive between 2008 and 2015 for this secondary data analysis. The risk of readmissions was described in proportion and trends. Reasons were coded according to the International Classification of Diseases, 10th Edition. Multivariable logistic regression was performed to identify factors associated with readmissions. Results Among 151729 patients, 11 to 13% were readmitted within 28 days post-discharge from their stroke events each year. The trend was constant for ischemic stroke but decreasing for hemorrhagic stroke. The leading causes for readmissions were recurrent stroke (32.1%), pneumonia (13.0%) and sepsis (4.8%). The risk of 28-day readmission was higher among those with stroke of hemorrhagic (adjusted odds ratio (AOR): 1.52) and subarachnoid hemorrhage (AOR: 2.56) subtypes, and length of index admission >3 days (AOR: 1.48), but lower among younger age groups of 35–64 (AORs: 0.61–0.75), p values <0.001. Conclusion The risk of 28-day readmission remained constant from 2008 to 2015, where one in eight stroke patients required readmission, mainly attributable to preventable causes. Age, ethnicity, stroke subtypes and duration of the index admission influenced the risk of readmission. Efforts should focus on minimizing potentially preventable admissions, especially among those at higher risk.

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Patient and Hospital Factors associated with 30-Day Unplanned Readmission in Patients with Stroke

Cited by 6 publications

References 36 publications

Enablers and barriers in hospital‐to‐home transitional care for stroke survivors and caregivers: A systematic review

Enablers and barriers in hospital‐to‐home transitional care for stroke survivors and caregivers: A systematic review

Risk factors for 30-day readmission in patients with ischemic stroke: a systematic review and meta-analysis

Risk of 28-day readmissions among stroke patients in Malaysia (2008–2015): Trends, causes and its associated factors

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