Stroke Patients Have Chronic Disease At High Risk For Readmissions

Cheryl Bushnell, MD, MHS Associate Professor of Neurology Director, Wake Forest Baptist Stroke Center Wake Forest Baptist School of Medicine Winston Salem, NC  27157MedicalResearch.com Interview with:
Cheryl Bushnell, MD, MHS
Associate Professor of Neurology
Director, Wake Forest Baptist Stroke Center
Wake Forest Baptist School of Medicine
Winston Salem, NC  27157

MedicalResearch: What are the main findings of the study?

Dr. Bushnell: We found that readmitted patients were significantly more likely to have more severe strokes, and to have been hospitalized two or more times during the year prior to the initial stroke admission, independent of other clinical factors, such as congestive heart failure, heart disease, or stroke complications (pneumonia, acute renal failure).

MedicalResearch Were any of the findings unexpected?

Dr. Bushnell: Not really.  For patients who are hospitalized frequently and then have stroke, it is not surprising that they might be readmitted within 30 days of stroke discharge.  However, what we also found is that regardless of a lack of hospitalizations prior to the stroke, the stroke appears to be a harbinger of readmissions even after 30 days.

MedicalResearch What should clinicians and patients take away from your report?

Dr. Bushnell: This illustrates that stroke is a chronic disease—in other words, stroke patients are at high risk for more hospitalizations because of having a stroke.  As a result, these patients may not be receiving appropriate post-acute services, including primary care, stroke specialty care, rehabilitation, and community services to keep them home and out of the hospital.

MedicalResearch What recommendations do you have for future research as a result of this study?

Dr. Bushnell: If our model is validated in a larger study, it could then be used in electronic health records to provide a potentially reproducible, efficient and effective means of selecting patients most at risk for subsequent hospital readmission (prior to discharge).  A logical next step is to develop innovative tools and programs for stroke patients, focused on post-acute services, to keep patients from being readmitted.

Citation:

Predictors of 30-Day Hospital Readmission Following Ischemic and Hemorrhagic Stroke

Strowd RE1, Wise SM1, Umesi UN1, Bishop L1, Craig J2, Lefkowitz D1, Reynolds PS1, Tegeler C1, Arnan M1, Duncan PW1, Bushnell CD3.
Am J Med Qual. 2014 Jun 11. pii: 1062860614535838. [Epub ahead of print]

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