Key result
Readmission to acute care during stroke rehabilitation was associated with higher medical complexity, lower functional scores, and a significantly higher rate of sedative/hypnotic prescription (82% vs. 23%, P<0.001).
Why the study?
The causes for readmission to acute care among patients admitted to an inpatient rehabilitation facility after stroke remained to be identified.
What are the causes and risk factors for readmission to acute care during inpatient rehabilitation after stroke?
Case-Control (n=178)
No
What are the causes and risk factors for readmission to acute care during inpatient rehabilitation after stroke?
Absolute Event Rate: 82% vs 23%
p-value: p=<0.001
Higher medical complexity and sedative/hypnotic prescriptions are associated with an increased risk of acute care readmission during stroke rehabilitation.
Highlights potential readmission triggers in post-stroke rehab; hypothesis-generating and should not yet change practice.
OBJECTIVE: The aim of the study was to identify causes for readmission to acute care of patients admitted to inpatient rehabilitation facility after stroke. DESIGN: The institutional Uniform Data System for Medical Rehabilitation database was used to identify stroke patients who experienced readmission to acute care and an equal number of age-/sex-matched group of patients who successfully completed their inpatient rehabilitation facility stay during 2005-2018. Retrospective chart review was used to extract clinical data. The two study groups were compared using univariate and multivariate analyses. RESULTS: The rate of readmission to acute care was 4.7% (n = 89; age = 65 ± 14 yrs; 37% female; 65% White; 73% ischemic stroke). The most common indications for transfer were neurological (31%) and cardiovascular (28%). Compared with control group, the readmission to acute care group had statistically higher rates of comorbid conditions, lower median (interquartile range) Functional Independence Measure score on inpatient rehabilitation facility admission (55 [37-65] vs. 64 [51-78], P < 0.001), and a higher rate of sedative/hypnotic prescription (82% vs. 23%, P < 0.001). CONCLUSIONS: Readmission to acute care is not common in our cohort. Patients who experienced readmission to acute care had higher medical complexity and were prescribed more sedative/hypnotic medications than the control group. Practitioners should be vigilant in patients who meet these criteria.
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Herrmann et al. (2021) conducted a case-control in Stroke (n=178). Readmission to acute care vs. Successful completion of inpatient rehabilitation was evaluated on Sedative/hypnotic prescription (p=<0.001). Readmission to acute care during stroke rehabilitation was associated with higher medical complexity, lower functional scores, and a significantly higher rate of sedative/hypnotic prescription (82% vs. 23%, P<0.001).
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