Complications following incident stroke resulting in readmissions: an analysis of data from three Scottish health surveys

Ponomarev, D., Miller, C. , Govan, L. , Haig, C. , Wu, O. and Langhorne, P. (2015) Complications following incident stroke resulting in readmissions: an analysis of data from three Scottish health surveys. International Journal of Stroke, 10(6), pp. 911-917. (doi:10.1111/ijs.12191) (PMID:24206656)

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Abstract

Background and aims: Stroke is widely recognized as the major contributor to morbidity and mortality in the United Kingdom. We analyzed the data obtained from the three consecutive Scottish Health Surveys and the Scottish Morbidity records, with the aim of identifying risk factors for, and timing of, common poststroke complications. Methods: There were 19434 individuals sampled during three Scottish Health Surveys in 1995, 1998, and 2001. For these individuals their morbidity and mortality outcomes were obtained in 2007. Incident stroke prevalence, risk factors for a range of poststroke complications, and average times until such complications in the sample were established. Results: Of the total of 168 incident stroke admissions (0·86% of the survey), 16·1% people died during incident stroke hospitalization. Of the remaining 141 stroke survivors, 75·2% were rehospitalized at least once. The most frequent reason for readmission after stroke was a cardiovascular complication (28·6%), median time until event 1412 days, followed by infection (17·3%, median 1591 days). The risk of cardiovascular readmission was higher in those with ‘poor’ self-assessed health (odds ratio 7·70; 95% confidence interval 1·64–43·27), smokers (odds ratio 4·24; 95% confidence interval 1·11–21·59), and doubled with every five years increase in age (odds ratio 1·97; 95% confidence interval 1·46–2·65). ‘Poor’ self-assessed health increased chance of readmission for infection (odds ratio 14·11; 95% confidence interval 2·27–276·56). Conclusions: Cardiovascular events and infections are the most frequent poststroke complications resulting in readmissions. The time period until event provides a possibility to focus monitoring on those people at risk of readmission and introduce preventative measures, thereby reducing readmission-associated costs.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Govan, Dr Lindsay and Langhorne, Professor Peter and Miller, Dr Claire and Wu, Professor Olivia and Haig, Dr Caroline
Authors: Ponomarev, D., Miller, C., Govan, L., Haig, C., Wu, O., and Langhorne, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Science and Engineering > School of Mathematics and Statistics > Statistics
Journal Name:International Journal of Stroke
Publisher:Wiley
ISSN:1747-4930
ISSN (Online):1747-4949
First Published:First published International Journal of Stroke 10(6):911-917

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