Key result
Roughly ~15% of stroke survivors face one-year readmission, predicted by elevated admission temperature and low GCS.
Why the study?
Data on the burden, reasons, and predictors of stroke readmission in most sub-Saharan African countries are lacking.
Cohort (n=198)
Yes
Hospital readmission after stroke discharge is common in Cameroon, often due to infections and recurrent stroke, and is associated with high mortality.
Answers are grounded in this paper and cite their sources.
Identifies high-risk stroke survivors for closer monitoring in Cameroon; hypothesis-generating for targeted prevention in sub-Saharan cohorts.
BACKGROUND: Hospital readmission after discharge for stroke is associated with high morbidity and mortality. There is a paucity of data on the burden of stroke readmission in most sub-Saharan African countries. We aimed to determine the rate, reasons and predictors of hospital readmission and the mortality rate within 12 months of discharge among stroke survivors in Cameroon. METHODS: This prospective cohort included patients who survived hospitalization for an acute stroke and who were discharged from two referral hospitals in the capital city of Cameroon between January 2013 and December 2013.We performed logistic regression analysis to identify demographic and clinical factors associated with readmission within 1 year of discharge and causes of readmission. RESULTS: Of the 254 consecutive patients admitted for acute stroke, 198 were discharged alive. There were 107 (54%) males, and their mean age (SD) was 61.7 (13.9) years (range: 10 to 95 years). A total of 30 (15.2%) patients were readmitted following discharge from the index admission over a mean follow-up time of 286.9 (127.6) days. Of these, 14 (46.7%) were discharged and 16 (53.3%) died after readmission. Thirty percent (30%) of readmissions occurred within the first month. The most frequent causes of readmissions were infections (30%) and recurrent stroke (26.7%). Factors associated with readmission in bivariate analysis were initial admission temperature > 37.5°C (risk ratio [RR]: 1.3, p = 0.021) and initial admission Glasgow Coma Score < 14 (RR: p = 1.23, p = 0.019). After stratified adjustment for age and sex, temperature > 37.5°C (adjusted RR: 1.3, 95% CI: 1-1.7, p = 0.036) and GCS <14 (adjusted RR: 1.23, 95% CI: 1-1.6, p = 0.041) were associated with readmission. CONCLUSION: Readmission after discharge for stroke was common with nearly one third occurring within the first month and more than half dying following readmission. The most common causes of readmission were infections and recurrent stroke.
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Nkoké et al. (2024) conducted a cohort in acute stroke (n=198). Among stroke survivors in Cameroon, 15.2% were readmitted within 1 year, with initial admission temperature >37.5°C (aRR 1.3) and GCS <14 (aRR 1.23) being significant predictors of readmission.
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