Perioperative Stroke and Readmissions Rates in Noncardiac Non-Neurologic Surgery.
J Stroke Cerebrovasc Dis
; 29(6): 104792, 2020 Jun.
Article
em En
| MEDLINE
| ID: mdl-32280000
ABSTRACT
BACKGROUND AND AIM:
Perioperative stroke is a feared and potentially disastrous complication of surgery. Postdischarge care, specifically hospital readmissions, can significantly impact postsurgical recovery and provides a useful metric for quality care. Our primary aim was examining 30-day readmissions for patients who had a perioperative stroke undergoing noncardiac non-neurosurgery.METHODS:
We analyzed data from the State Inpatient Database, a database of community hospital discharges, in California between 2008 and2011. Surgical patients undergoing one of the 10 highest-volume procedures were included; patients less than 18 years old, undergoing pregnancy-related procedures, or who died in-hospital were excluded. Our dataset covariates included demographic and clinical variables, comorbidities, and discharge location. After running an initial bivariate analysis using Chi-square and t-tests and testing for multicollinearity, logistical models were run to calculate adjusted odds ratios and confidence intervals for readmission predictors.RESULTS:
30-day readmissions for patients with perioperative stroke (nâ¯=â¯1613) occurred at a rate of 21.08% (340 patients), compared to 6.29% (63,856 patients) for patients without perioperative stroke (adjusted ORâ¯=â¯1.40, 95% CI 1.23-1.59, P < .0001). Demographic predictors of 30-day readmissions included male sex and African-American race. Clinical predictors of 30-day readmissions included several comorbidities (i.e. liver disease, hypertension), and discharge to a postacute care facility. Key 30-day readmission diagnoses for perioperative stroke patients included septicemia, stroke, aspiration pneumonitis, and urinary tract infections.CONCLUSIONS:
Patients with perioperative stroke have high 30-day readmissions rates. A number of demographic and clinical factors increase readmission risk in this population. Further research is warranted to better support patients with perioperative stroke undergoing care transitions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
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Procedimentos Cirúrgicos Operatórios
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Acidente Vascular Cerebral
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Pacientes Internados
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article