4.5 Article

Readmission to an Acute Care Hospital During Inpatient Rehabilitation After Stroke

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出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PHM.0000000000001844

关键词

Stroke Rehabilitation; Patient Transfer; Patient Readmission; Rehabilitation Centers; Inpatients

资金

  1. Research, Education, and Development fund through Regions Hospital, St Paul, MN

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The study aimed to identify reasons for readmission to acute care after stroke patients underwent inpatient rehabilitation. The results showed that readmission to acute care was not common, but patients who were readmitted had higher medical complexity and were more likely to be prescribed sedative/hypnotic medications.
Objective The aim of the study was to identify causes for readmission to acute care of patients admitted to inpatient rehabilitation facility after stroke. Design The institutional Uniform Data System for Medical Rehabilitation database was used to identify stroke patients who experienced readmission to acute care and an equal number of age-/sex-matched group of patients who successfully completed their inpatient rehabilitation facility stay during 2005-2018. Retrospective chart review was used to extract clinical data. The two study groups were compared using univariate and multivariate analyses. Results The rate of readmission to acute care was 4.7% (n = 89; age = 65 +/- 14 yrs; 37% female; 65% White; 73% ischemic stroke). The most common indications for transfer were neurological (31%) and cardiovascular (28%). Compared with control group, the readmission to acute care group had statistically higher rates of comorbid conditions, lower median (interquartile range) Functional Independence Measure score on inpatient rehabilitation facility admission (55 [37-65] vs. 64 [51-78], P < 0.001), and a higher rate of sedative/hypnotic prescription (82% vs. 23%, P < 0.001). Conclusions Readmission to acute care is not common in our cohort. Patients who experienced readmission to acute care had higher medical complexity and were prescribed more sedative/hypnotic medications than the control group. Practitioners should be vigilant in patients who meet these criteria.

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