Systematic review of hospital readmissions in stroke patients

Background Previous evidence on factors and causes of readmissions associated with high-impact users of stroke is scanty. The aim of the study was to investigate common causes and pattern of short- and long-term readmissions stroke patients by conducting a systematic review of studies using hospital administrative data. Common risk factors associated with the change of readmission rate were also examined. Methods The literature search was conducted from 15th February to 15th March 2016 using various databases, such as Medline, Embase, and Web of Science. Results There were total of 24 studies (n=2,126,617) included in the review. Only 4 studies assessed causes of readmissions in stroke patients with the follow-up duration from 30 days to 5 years. Common causes of readmissions in majority of the studies were recurrent stroke, infections and cardiac conditions. Common patient-related risk factors associated with increased readmission rate were age and history of coronary heart disease, heart failure, renal disease, respiratory disease, peripheral arterial disease and diabetes. Among stroke-related factors, length of stay of index stroke admission was associated with increased readmission rate, followed by bowel incontinence, feeding tube and urinary catheter. Conclusion Although risk factors and common causes of readmission were identified, but none of the previous studies investigated causes and their sequence of readmissions among high-impact stroke users