Rate and Predictors of Acute Care Encounters in the First Month After Stroke

Hussein, Haitham M.; Chrenka, Ella; Herrmann, Amanda A

doi:10.1016/j.jstrokecerebrovasdis.2022.106466

Cited by 2 publications

(4 citation statements)

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“…A recent study that analyzed the risk factors and common causes of PPRs in older patients (mean age = 85 yrs) found similar results, noting that acute heart failure, pulmonary edema, sepsis, pneumonia, and stroke made up common causes for readmissions 3 . In another study by our group that focused on acute care encounters after stroke discharge, postdischarge primary care visit within 1 wk was associated with a decreased need for acute care encounters 8 . In this current study, we do not have information regarding postdischarge follow-up but because increased medical complexity requires more medical supervision, it follows that such patients require more discharge coordination than those with fewer medical comorbidities.…”

Section: Discussionsupporting

confidence: 69%

“…The PPR group had significantly more medical comorbidities than the control group, and the most common causes for PPRs were infection and inadequate management of chronic conditions, rather than injury or unplanned events. We have noted the association between high burden of medical comorbidities and readmission in two previous studies 7,8 . A recent study that analyzed the risk factors and common causes of PPRs in older patients (mean age = 85 yrs) found similar results, noting that acute heart failure, pulmonary edema, sepsis, pneumonia, and stroke made up common causes for readmissions 3 .…”

Section: Discussionmentioning

confidence: 56%

“…We have noted the association between high burden of medical comorbidities and readmission in two previous studies. 7,8 A recent study that analyzed the risk factors and common causes of PPRs in older patients (mean age = 85 yrs) found similar results, noting that acute heart failure, pulmonary edema, sepsis, pneumonia, and stroke made up common causes for readmissions. 3 In another study by our group that focused on acute care encounters after stroke discharge, postdischarge primary care visit within 1 wk was associated with a decreased need for acute care encounters.…”

Section: Discussionmentioning

confidence: 77%

“…3 In another study by our group that focused on acute care encounters after stroke discharge, postdischarge primary care visit within 1 wk was associated with a decreased need for acute care encounters. 8 In this current study, we do not have information regarding postdischarge follow-up but because increased medical complexity requires more medical supervision, it follows that such patients require more discharge coordination than those with fewer medical comorbidities. Therefore, while the PPR definition might be met, it does not necessarily reflect the quality of care provided by the IRF; rather, it may indicate a break in the continuation of care after discharge, which is not always under the control of the IRF providers.…”

Section: Discussionmentioning

confidence: 93%

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Potentially Preventable Readmissions after Acute Inpatient Rehabilitation

Herrmann

Chrenka

Seth

et al. 2023

Am J Phys Med Rehabil

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Objective The aim of the study is to identify causes and risk factors for potentially preventable readmissions of patients discharged from an inpatient rehabilitation facility. Design Our hospital billing database was used to identify patients discharged from our inpatient rehabilitation facility between 2013 and 2018 and experienced a potentially preventable readmission within 90 days (n = 75). Retrospective chart review was completed to obtain clinical data. Of the patients discharged from the inpatient rehabilitation facility who did not experience a potentially preventable readmission, a group of age- and sex-matched controls (n = 75) was randomly selected. The two study groups were compared using univariate and multivariate analyses. Results Our study found that individuals who discharged from acute inpatient rehabilitation were more likely to be readmitted with a potentially preventable readmission if they have a greater number of comorbidities, were admitted initially with a spinal cord injury, or have lower admission or discharge Functional Independence Measure motor scores. The most common potentially preventable readmission diagnoses were sepsis, renal failure, respiratory problems, and urinary tract infection. Conclusions Identifying patients with the common causes for potentially preventable readmissions, in addition to the noted risk factors, is an important consideration for inpatient rehabilitation discharge planning.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 56%