Boston University School of Medicine, Department of Neurology, United States.
Boston University School of Medicine, United States.
J Neurol Sci. 2018 Feb 15;385:83-86. doi: 10.1016/j.jns.2017.12.016. Epub 2017 Dec 14.
The purpose of this study is to identify predictors of stroke-related readmissions at 30days on a safety net hospital level and suggest interventions to reduce the number of readmissions.
Hospital readmissions are an important measure of the quality of health care services. Readmissions indicate unresolved problems from the index admission, inadequate post-hospitalization care, or a mixture of these factors. Additionally, hospital readmissions are associated with a substantial economic burden on the health care system. The study's purpose is to identify predictors of stroke-related readmissions within 30days on a hospital level and suggest interventions to reduce the number of readmissions.
We conducted a single-center retrospective study of patients admitted to Boston Medical Center (BMC) and diagnosed with ischemic and hemorrhagic stroke. Unadjusted and adjusted logistic regressions were used to evaluate possible predictors of stroke related readmissions.
Of 352 patients admitted with a diagnosis of ischemic or hemorrhagic stroke at BMC during the study period, 44 (12.5%) patients were readmitted to BMC within 30days. Current alcohol abuse was significantly associated with readmission (OR 95% CI 1.03-5.62). Discharge against medical advice was also associated, though the sample size was small.
These results suggest that early inpatient and post-hospitalization interventions to address alcohol abuse during the index hospital admission may reduce the rate of hospital readmission within 30days. The results have prompted interventions on the stroke service such as early inpatient social work and addiction medicine involvement for patients with risk factors of alcohol abuse.
本研究旨在确定安全网医院层面 30 天内与中风相关的再入院的预测因素，并提出减少再入院数量的干预措施。
医院再入院是医疗服务质量的一个重要衡量标准。再入院表明索引入院仍存在未解决的问题、出院后护理不足，或者这两个因素兼而有之。此外，医院再入院与医疗系统的巨大经济负担有关。本研究的目的是确定安全网医院层面 30 天内与中风相关的再入院的预测因素，并提出减少再入院数量的干预措施。
我们对波士顿医疗中心（BMC）收治的被诊断为缺血性和出血性中风的患者进行了一项单中心回顾性研究。采用未调整和调整后的逻辑回归来评估与中风相关的再入院的可能预测因素。
在研究期间，352 名被诊断为缺血性或出血性中风的患者在 BMC 住院，其中 44 名（12.5%）患者在 30 天内再次入住 BMC。目前酗酒与再入院显著相关（OR 95%CI 1.03-5.62）。虽然样本量较小，但不遵医嘱出院也与再入院相关。
这些结果表明，在索引住院期间针对酗酒问题进行早期住院内和出院后干预，可能会降低 30 天内的医院再入院率。这些结果促使对中风服务进行干预，例如为有酗酒风险因素的患者提供早期住院内社会工作和成瘾医学干预。
