Temporal trends and risk factors for readmission for infections, gastrointestinal and immobility complications after an incident hospitalisation for stroke in Scotland between 1997 and 2005

Lewsey, J. et al. (2015) Temporal trends and risk factors for readmission for infections, gastrointestinal and immobility complications after an incident hospitalisation for stroke in Scotland between 1997 and 2005. BMC Neurology, 15(3), (doi: 10.1186/s12883-014-0257-1) (PMID:25591718) (PMCID:PMC4320501)

Abstract

Background: Improvements in stroke management have led to increases in the numbers of stroke survivors over the last decade and there has been a corresponding increase of hospital readmissions after an initial stroke hospitalisation. The aim of this study was to examine the one year risk of having a readmission due to infective, gastrointestinal or immobility (IGI) complications and to identify temporal trends and any risk factors.<p></p> Methods: Using a cohort of first hospitalised for stroke patients who were discharged alive, time to first event (readmission for IGI complications or death) within 1 year was analysed in a competing risks framework using cumulative incidence methods. Regression on the cumulative incidence function was used to model the risks of having an outcome using the covariates age, sex, socioeconomic status, comorbidity, discharge destination and length of hospital stay.<p></p> Results: There were a total of 51,182 patients discharged alive after an incident stroke hospitalisation in Scotland between 1997–2005, and 7,747 (15.1%) were readmitted for IGI complications within a year of the discharge. Comparing incident stroke hospitalisations in 2005 with 1997, the adjusted risk of IGI readmission did not increase (HR = 1.00 95% CI (0.90, 1.11). However, there was a higher risk of IGI readmission with increasing levels of deprivation (most deprived fifth vs. least deprived fifth HR = 1.16 (1.08, 1.26).<p></p> Conclusions: Approximately 15 in 100 patients discharged alive after an incident hospitalisation for stroke in Scotland between 1997 and 2005 went on to have an IGI readmission within one year. The proportion of readmissions did not change over the study period but those living in deprived areas had an increased risk.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacIntyre, Dr Kate and Langhorne, Professor Peter and Jhund, Professor Pardeep and Briggs, Professor Andrew and Gillies, Dr Michelle and Lewsey, Professor Jim and Capewell, Dr Simon and McMurray, Professor John and Walters, Professor Matthew
• Authors: Lewsey, J., Ebueku, O., Jhund, P. S., Gillies, M., Chalmers, J. W.T., Redpath, A., Briggs, A., Walters, M., Langhorne, P., Capewell, S., McMurray, J. J.V., and MacIntyre, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: BMC Neurology
• Publisher: BioMed Central
• ISSN: 1471-2377
• ISSN (Online): 1471-2377
• Copyright Holders: Copyright © 2015 The Authors
• First Published: First published in BMC Neurology 15(3)
• Publisher Policy: Reproduced under a Creative Commons License