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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

Citation

Lewsey, J and Ebeuku, O and Jhund, PS and Gillies, M and Chalmers, JWT and Redpath, A and Briggs, A and Walters, M and Langhorne, P and Capewell, S and McMurray, JJV and Macintyre, K, 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 Article 3. ISSN 1471-2377 (2015) [Refereed Article]


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Copyright Statement

Copyright 2015 The Authors-This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

DOI: doi:10.1186/s12883-014-0257-1

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.

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.

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).

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 Details

Item Type:Refereed Article
Keywords:Incident stroke hospitalisation, Readmission, Cumulative incidence, Competing risks
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Macintyre, K (Dr Kate Macintyre)
ID Code:97975
Year Published:2015
Web of Science® Times Cited:2
Deposited By:Paramedicine
Deposited On:2015-01-23
Last Modified:2017-11-03
Downloads:239 View Download Statistics

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