Key result
Large-artery atherosclerosis (17.2%) and stroke of other determined aetiology (18.8%) subtypes had significantly higher risks of 30-day readmission compared to the overall cohort rate of 10.7%.
Why the study?
Stroke aetiology may affect the risk and causes of readmission after ischaemic stroke and TIA due to differences in risk factors, functional outcome, and treatment.
Does ischaemic stroke subtype affect the risk of 30-day hospital readmission in patients surviving an ischaemic stroke or TIA?
Cohort (n=1,874)
Does ischaemic stroke subtype affect the risk of 30-day hospital readmission in patients surviving an ischaemic stroke or TIA?
Patients with large-artery atherosclerosis or stroke of other determined aetiology have a significantly higher risk of 30-day readmission, which is an independent predictor of one-year mortality.
Answers are grounded in this paper and cite their sources.
Patients with LAA or SOE subtypes may need closer post-discharge surveillance; hypothesis-generating for targeted prevention trials.
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 large-artery 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.
No takes yet. Share an insight, caveat, or question.
Bjerkreim et al. (2018) conducted a cohort in Ischaemic stroke (IS) and transient ischaemic attack (TIA) (n=1,874). Ischaemic stroke subtype was evaluated on 30-day unplanned hospital readmission. Large-artery atherosclerosis (17.2%) and stroke of other determined aetiology (18.8%) subtypes had significantly higher risks of 30-day readmission compared to the overall cohort rate of 10.7%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: