Stroke Research and Treatment

Review Article

Systematic Review of Hospital Readmissions in Stroke Patients

Table 5

Studies demonstrating risk factors that increased readmission rate. The rate of increase was described as hazard ratio (HR), odds ratio (OR), relative risk (RR), or increase in the percentage.


Studies	Outcome measured	Risk factors

Chu et al. 2015 [33]	14 d readmission for infective endocarditis	Valvular heart disease (OR 1.5; 95% CI, 0.2–10.8)
		Prosthetic heart valve (OR 15.8; 95%CI, 1.9–129.0)
		Urinary tract infection (OR 3.5; 95% CI, 1.0–12.3)

Lichtman et al. 2013 [20]	All-cause 30 d readmission	Female sex (HR 1.14; 95% CI, 1.08–1.21)
		Age (per year increase) (HR 1.02; 95% CI, 1.01–1.02)
		Diabetes (HR 1.43; 95% CI, 1.35–1.51)
		Congestive heart failure (HR 2.29; 95% CI, 2.15–2.43)
		Myocardial infarction (HR 1.54; 95% CI, 1.29–1.85)
		Peripheral vascular disease (HR 1.14; 95% CI, 1.05–1.24)
		Unstable angina (HR 1.49; 95% CI, 1.11–1.98)
		Protein malnutrition (HR 1.43; 95% CI, 1.23–1.67)
		Dementia (HR 1.10; 95% CI, 1.02–1.20)
		Anaemia (HR 1.43; 95% CI, 1.35–1.51)
		Renal failure (HR 2.31; 95% CI, 2.14–2.48)
		Pneumonia (HR 1.28; 95% CI 1.59–1.42)

Burke et al. 2014 [11]	All-cause 30 d readmission	Use of hospice care (OR 5.86; 95% CI, 1.13–30.3)

Howrey et al. 2011 [27]	All-cause 30 d readmission	Hospitalist care (versus nonhospitalist) (HR 1.30; 95% CI, 1.11–1.52)

Smith et al. 2005 [16]	All-cause 30 d readmission	Care by health maintenance organisation (HMO) compared to Fee-For-Service (FFS) health insurance (HR 1.45; 95%, 1.14–1.83)

Smith et al. 2006 [13]	30 d readmission for atherosclerotic diseases	Care by neurologist (versus generalist) (HR 1.17; 95% CI, 1.02–1.34)

Fehnel et al. 2015 [29]	Unplanned 30-day readmission	Bowel incontinence (OR 1.16; 95% CI, 1.06–1.28)
		Feeding tube (OR 1.21; 95% CI, 1.08–1.35)
		Chronic obstruction pulmonary disease (OR 1.26; 95% CI, 1.16–1.38)
		Renal disease (OR 1.26; 95% CI, 1.13–1.42)
		Heart failure (OR 1.17; 95% CI, 1.08–1.27)
		Pressure ulcer grade 4 (OR 1.33; 95% CI, 1.09–1.62)

Tseng and Lin 2009 [6]	1 yr all-cause readmission	Care by nonneurologist (versus neurologist) (OR 1.81; 95% CI, 1.13–2.88)

Allen et al. 2010 [17]	1 yr readmission for recurrent stroke	Prior hospital admissions (RR 12.64; 95% CI, 9.24–17.29)
		High comorbidity score (RR 2.28; 95% CI, 1.18–2.90)

Lewsey et al. 2010 [25]	1-year readmissions for infections, gastrointestinal, and immobility complications	Heart failure (HR 1.19; 95% CI, 110–1.30)
		Renal failure (HR 1.23; 95% CI, 1.10–1.38)
		Respiratory disease (HR 1.24; 95% CI, 1.15–1.33)
		Increased age (HR 2.08; 95% CI, 1.87–2.31)
		Higher socioeconomic deprivation (HR 1.16; 95% CI, 1.08–1.26)
		Prior complications of infections (HR 1.31; 95% CI, 1.24–1.38)
		Prior gastrointestinal complications (HR 1.58; 95% CI, 1.51–1.66)
		Prior immobility complications (HR 1.23; 95% CI, 1.16–1.30)

Ghose et al. 2005 [23]	3 yr all-cause readmission rate	Depression during stroke (log-OR 2.09; 95% CI, 2.03–2.16)

Caro et al. 2006 [8]	5 yr all-cause readmission rate	36.2% (95% CI, 30.3%–42.4%) for age (>65 years)
		18.1% (95% CI, 14.1%–22.2%) for male sex
		20.9% (95% CI, 13.9%–28.4%) for atrial fibrillation
		21.6% (95% CI, 16.6%–26.8%) for heart failure
		12.1% (95% CI, 7.6%–17.8%) for angina
		10.1% (95% CI, 2.7%–14.8%) for prior myocardial infarction
		14.0% (95% CI, 9.7%–18.7%) for hypertension
		4% (95% CI, 0.2%–8.1%) for transient ischaemic attack