Infection as a Key Determinant of Readmission in Stroke Patients: A Systematic Review and Meta-Analysis

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Stroke is a leading cause of long-term disability and mortality.
• Patient readmission after stroke is a significant concern, impacting healthcare costs and patient outcomes.
• Identifying factors contributing to stroke readmission is crucial for developing effective prevention strategies.

Purpose of the Study:

• To determine the relationship between infection and hospital readmission in stroke patients.
• To quantify the risk of readmission associated with infections in stroke survivors.
• To provide evidence for targeted interventions to reduce infection-related stroke readmissions.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
• Comprehensive literature search across major databases (PubMed, Web of Science, CINAHL, Scopus, Google Scholar) up to 2024.
• Random effects model used to calculate readmission rates and Odds Ratios (OR) for infection as a risk factor.

Main Results:

• Stroke patient readmission rates due to infection range from 6.5% to 30.0% (30-day) and 5.1% to 24.5% (one-year).
• Infection is a significant risk factor for stroke readmission, with relative risks (RR) and Odds Ratios (OR) ranging from 1.31 to 1.68.
• Statistical significance was observed across cohort studies (RR 1.38, P<0.001), case-control studies (OR 1.68, P=0.006), and descriptive-analytical studies (OR 1.31, P=0.008).

Conclusions:

• Infection is a major contributor to stroke patient readmissions, necessitating urgent attention.
• A holistic strategy integrating clinical care, technological advancements, and patient education is vital to mitigate infection-related readmissions.
• Further research is needed to develop and evaluate comprehensive interventions for managing infection in stroke patients and reducing readmission rates.