Preventing infections could cut readmissions after stroke
MedWire News: Infections are the underlying cause of a high proportion of hospital admissions in stroke survivors, say Taiwanese researchers.
Overall, 31% of patients from the 2657-strong study cohort were readmitted within 1 year of discharge after stroke, report Mei-Chiun Tseng (National Sun Yat-Sen University, Kaohsiung) and colleagues.
They note that this rate is lower than in some previous studies. For example, a recent US study reported that two-thirds of patients die or are readmitted within a year of stroke.
"Regardless of the variation of rates, our study confirmed the magnitude of the burden, which necessitates the identification of high-risk patients for implementing preventive measures," say Tseng et al.
The cumulative probability of rehospitalization was 10% by 30 days after initial discharge, rising to 17% by 90 days, 24% by 180 days, and 36% by 360 days.
The most important reasons for rehospitalization were infection, which accounted for 28% of readmissions, followed by recurrent stroke and other cardiovascular events, which accounted for 18% and 10% of readmissions, respectively.
Infection was the most important cause of rehospitalization during the early phase of follow-up; the proportion of cases accounted for by infections peaked, at 34%, within the first 30 days after initial discharge. In contrast, readmissions for stroke and other cardiovascular events tended to rise over time.
The researchers note in the journal Neurology, that besides being the most common reason for readmission, infection is "arguably the most preventable one." They say: "The two most frequent infections - pneumonia and urinary tract infections - might relate to the neurologic deficits, such as dysphagia, sphincter dysfunction, and limited motor function, as well as quality of care and nutritional status after discharge.
"However, it is premature to predict how much improvement can be achieved."
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By Eleanor McDermid