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Death, Readmission Likely for Medicare Stroke Patients

Nearly two-thirds of those discharged after ischemic stroke die or are readmitted within year

FRIDAY, Dec. 17 (HealthDay News) -- Most Medicare beneficiaries discharged from the hospital after ischemic stroke either die or are rehospitalized within one year, according to a study published online Dec. 16 in Stroke.

Gregg C. Fonarow, M.D., of the University of California in Los Angeles, and colleagues evaluated outcome data from 91,134 Medicare fee-for-service beneficiaries treated at 625 Get With The Guidelines-Stroke hospitals between April 2003 and December 2006.

The investigators found that in-hospital unadjusted mortality was 6.1 percent, 30-day unadjusted mortality was 14.1 percent, and one-year unadjusted mortality was 31.1 percent. The investigators also found that the median hospital-level 30-day unadjusted death or readmission rate after discharge was 21.4 percent. Within one year of hospital discharge, the overall rate of death or rehospitalization was 61.9 percent. No improvements in death or rehospitalization were found between 2003 and 2006. Although hospital-level performance in risk-adjusted outcomes did not significantly differ by size or primary stroke center designation, academic hospitals and those located in the Northeast or West experienced slightly more favorable outcomes.

"These findings underscore the need to better understand the patterns and causes of deaths and readmission after ischemic stroke and to develop strategies aimed at avoiding those that are preventable," the authors conclude.

Several authors disclosed financial relationships with pharmaceutical companies.

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