One in Five Stroke Patients Return to Hospital

Site of initial discharge affects likelihood of complicated transition after acute stroke

MONDAY, March 12 (HealthDay News) -- Sociodemographic factors and the initial discharge site both play a role in the likelihood of acute stroke patients experiencing a difficult transition, such as bouncing back to the hospital or transferring from a less-intensive to a more-intensive care setting, according to the results of a study in the March issue of the Journal of the American Geriatrics Society.

Amy J.H. Kind, M.D., of the University of Wisconsin-Madison, and colleagues conducted a retrospective study of 39,384 Medicare beneficiaries who were discharged from 422 hospitals in the southern and eastern United States, following a diagnosis of acute ischemic stroke.

At least one complicated transition affected 20 percent of patients, and 16 percent had more than one. Those most likely to have complicated transitions were older, black, on Medicaid, were chronically ill or had a gastrostomy tube. Prior history of hospitalization, length of stay and discharge site were also factors; multiple complications were more likely among those initially discharged to a skilled-nursing facility or long-term care.

"Significant numbers of stroke patients experience complicated transitions soon after hospital discharge. Sociodemographic factors and initial discharge site distinguish patients with multiple complicated transitions. These factors may enable prospective identification and targeting of stroke patients at risk for 'bouncing back,'" the authors conclude.

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