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Stroke Research and Treatment
Volume 2016, Article ID 9325368, 11 pages
http://dx.doi.org/10.1155/2016/9325368
Review Article

Systematic Review of Hospital Readmissions in Stroke Patients

1School of Public Health, Faculty of Medicine, Dr. Foster Unit, 3 Dorset Rise, London EC4Y 8EN, UK
2Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, QEQM, St Mary’s Hospital, Floor 10, Praed Street, London W2 1NY, UK

Received 29 June 2016; Accepted 8 August 2016

Academic Editor: Graeme J. Hankey

Copyright © 2016 Ahsan Rao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Previous evidence on factors and causes of readmissions associated with high-impact users of stroke is scanty. The aim of the study was to investigate common causes and pattern of short- and long-term readmissions stroke patients by conducting a systematic review of studies using hospital administrative data. Common risk factors associated with the change of readmission rate were also examined. Methods. The literature search was conducted from 15 February to 15 March 2016 using various databases, such as Medline, Embase, and Web of Science. Results. There were a total of 24 studies (,126,617) included in the review. Only 4 studies assessed causes of readmissions in stroke patients with the follow-up duration from 30 days to 5 years. Common causes of readmissions in majority of the studies were recurrent stroke, infections, and cardiac conditions. Common patient-related risk factors associated with increased readmission rate were age and history of coronary heart disease, heart failure, renal disease, respiratory disease, peripheral arterial disease, and diabetes. Among stroke-related factors, length of stay of index stroke admission was associated with increased readmission rate, followed by bowel incontinence, feeding tube, and urinary catheter. Conclusion. Although risk factors and common causes of readmission were identified, none of the previous studies investigated causes and their sequence of readmissions among high-impact stroke users.