Predictors of Post-Stroke Hospital Readmission Identified

A new study suggests that stroke severity and the number of hospitalizations within the year prior to the stroke admission are important predictors of subsequent readmission.

To identify factors affecting stoke patient readmissions, researchers at Wake Forest Baptist Medical Center (Winston-Salem, NC, USA) and Mercy Hospital (Oklahoma City, OK, USA) conducted a retrospective case-control study of 79 patients with acute ischemic or hemorrhagic strokes who were readmitted to the same hospital within 30 days. The patients were compared to 86 frequency-matched controls, with no significant differences in age, gender, or race-ethnicity identified between the stroke patients and the controls.

The results showed that readmitted stroke patients were more likely to have had two or more hospitalizations in the year prior to stroke (21.5% versus 2.3% in controls). Readmitted patients were also significantly more likely to have a higher US National Institutes of Health Stroke Score (NIHSS) on admission, and prior diagnosis of congestive heart failure (CHF), coronary artery disease (CAD), cancer, or absence of hyperlipidemia in the blood. The study was published online on June 11, 2014, in the American Journal of Medical Quality.

“If you can recognize who is at risk, you can really focus on those people to try to make sure they are treated appropriately and followed closely,” said senior author Cheryl Bushnell, MD, director of the Wake Forest Baptist Comprehensive Stroke Center. “If our model is validated in a larger study, it could then be used in electronic health records to provide a potentially reproducible, efficient, and effective means of selecting patients most at risk for subsequent hospital readmission.”

Hospital readmission, an important measure of quality care, costs the United States an estimated USD 17 billion each year. Medicare (Baltimore, MD, USA) is trying to improve patient care by penalizing hospitals with poor outcomes. At the moment, penalties and withholding of reimbursements are levied against hospital with high readmission rates following heart attack, heart failure, or pneumonia, but may soon be widened to other causes as well.

Related Links:
Wake Forest Baptist Medical Center
Mercy Hospital
Medicare