Predictors of long-term survival after spontaneous intracerebral hemorrhage in southern Portugal: A retrospective study of a community representative population

Nzwalo, Hipólito; Félix, Catarina; Nogueira, Jerina; Guilherme, Patrı́cia; Ferreira, Fátima; Salero, Teresa; Ramalhete, Sara; Martinez, Joana; Mouzinho, Maria Manuel; Marreiros, Ana; Thomassen, Lars; Logallo, Nicola

doi:10.1016/j.jns.2018.09.019

Cited by 4 publications

(1 citation statement)

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“…This was shown in a study of 356 patients with intracerebral hemorrhage in Portugal, where readmission within one year led to a five-fold increase in two-year mortality. 233 A reason for the mediating effect readmission has on mortality might be that post-stroke complications requiring hospital readmissions lead to higher disability. Less severe complications, such as urinary tract infections and simple fractures can be treated in primary health care, while more severe complications require hospitalization.…”

Section: The Impact Of Hospital Readmissions On Mortalitymentioning

confidence: 99%

Five-year readmission and mortality differ by ischemic stroke subtype

Bjerkreim

Khanevski

Thomassen

et al. 2019

Journal of the Neurological Sciences

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Background. Stroke aetiology may affect the risk and causes of readmission after ischaemic stroke (IS) and transient ischaemic attack (TIA) due to differences in risk factors, functional outcome, and treatment. We aimed to examine frequencies, causes, and risk of 30-day readmission by stroke subtype, determine predictors of 30-day readmission, and study the impact of 30-day readmissions on one-year mortality. Methods. All surviving patients admitted with IS or TIA from July 2007 to December 2013 were followed by review of medical records for all unplanned readmissions within 30 days after discharge. Stroke subtype was classified as largeartery atherosclerosis (LAA), cardioembolism (CE), small vessel occlusion (SVO), stroke of other determined aetiology (SOE), or stroke of undetermined aetiology (SUE). Cox regression analyses were performed to assess the risk of 30-day readmission for the stroke subtypes and identify predictors of 30-day readmission, and its impact on one-year mortality. Results. Of 1874 patients, 200 (10.7%) were readmitted within 30 days [LAA 42/244 (17.2%), CE 75/605 (12.4%), SVO 12/205 (5.9%), SOE 6/32 (18.8%), SUE 65/788 (8.3%)]. The most frequent causes of readmissions were stroke-related event, infection, recurrent stroke/ TIA, and cardiac disease. After adjusting for age, sex, functional outcome, length of stay, and the risk factor burden, patients with LAA and SOE subtype had significantly higher risks of readmission for any cause, recurrent stroke or TIA, and stroke-related events. Predictors of 30-day readmission were higher age, peripheral arterial disease, enteral feeding, and LAA subtype. Thirty-day readmission was an independent predictor of one-year mortality. Conclusions. Patients with LAA or SOE have a high risk of 30-day readmission, possibly caused by an increased risk of recurrent stroke and stroke-related events. Awareness of the risk of readmission for different causes and appropriate handling according to stroke subtype may be useful for preventing some readmissions after stroke.

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Section: The Impact Of Hospital Readmissions On Mortalitymentioning

confidence: 99%