Factors associated with post-stroke readmission: a systematic review and meta analysis

Area of Science:

• Neurology
• Public Health
• Healthcare Management

Background:

• Stroke readmissions are a significant concern, impacting patient outcomes and healthcare costs.
• Reducing hospital readmissions is a national healthcare reform goal, particularly for conditions like stroke.
• Identifying factors associated with stroke readmissions is crucial for developing effective prevention strategies.

Purpose of the Study:

• To systematically review and meta-analyze factors associated with 30-day, 90-day, and 1-year ischemic stroke readmissions.
• To identify modifiable factors that can help mitigate the risk of stroke readmission.
• To inform healthcare policies and practices aimed at reducing stroke readmission rates.

Main Methods:

• Systematic review and meta-analysis of English-language studies.
• Searched PubMed and Web of Science databases for studies published between January 1, 2000, and February 5, 2024.
• Included 135 studies from 18 countries, analyzing factors influencing 30-day, 90-day, and 1-year stroke readmissions.

Main Results:

• Higher 30-day readmissions linked to advanced age, insurance type, socioeconomic disadvantage, and comorbidities (heart failure, diabetes).
• Effective discharge planning, post-primary care visits, and thrombolytic therapy were associated with reduced 30-day readmissions.
• In the U.S., 30-day readmissions increased with atrial fibrillation and cancer, but decreased with discharge to home and private insurance.

Conclusions:

• Advanced age, comorbidities, and discharge planning significantly impact 90-day readmissions.
• 1-year readmissions are influenced by advanced age, discharge location, functional independence, and chronic diseases.
• Improving hospital discharge procedures and follow-up care are key modifiable factors for reducing stroke readmission rates.