PTCohortJournal of rehabilitation medicine2021

Hospital readmission in stroke survivors one year versus three years after discharge from inpatient rehabilitation: Prevalence and associations in an Asian cohort.

Matthew Rong Jie Tay

PMID 34096610

WHAT IT FOUND

24.0% of stroke survivors were readmitted within one year.

Recurrent stroke, falls, seizures, pneumonia, and urinary tract infection were listed causes. Comorbidity, inpatient complications, and lower function at rehabilitation admission were associated with readmission.

Key findings

01383 patients (31.0%) were readmitted over 3 years, including 296 (24.0%) within one year and 87 (7.0%) in years one to three.

02Within one year, the listed primary causes included recurrent stroke (59), falls (49), pneumonia (30), seizure (30), and urinary tract infection (29).

03A Charlson Comorbidity Index score of 1 or more was a risk factor for readmission within one year (OR 2.88) and in years one to three (OR 23.87).

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The methods report 1,158 patients screened and 23 ineligible, while Table I lists n=1,235, so the analysed number is not fully clear. The study looked backward at records and did not assign treatments, so it cannot show what caused readmission. It was done at one Singapore rehabilitation centre, so it may not apply to other health systems. Family support and socioeconomic status were not available, so some risk may be unexplained. Some readmissions outside the regional hospital group may have been missed, though a local study found less than 6% incidence. Patients who died during the index admission or were discharged to palliative care were excluded, so the sickest patients are not represented.

The easy way to misread this

Do not conclude that more rehabilitation caused fewer readmissions. The study linked greater FIM gain to lower readmission odds, but it did not randomise rehabilitation and cannot separate therapy effects from baseline function.

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