Journal of Korean Biological Nursing Science

Korean society of Biological Nursing Science (한국기초간호학회)
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Factors Affecting Readmission After Discharge in Stroke Patients: A Retrospective Study

뇌졸중 환자의 퇴원 후 재입원에 영향을 미치는 요인: 후향적 연구

  • Kang, Ae Jeong (Gyeongsang National University Changwon Hospital) ;
  • Lee, Song Hee (Gyeongsang National University Changwon Hospital) ;
  • Kim, Rock Beum (Prevention and Management Center, Gyeongsang National University Hospital) ;
  • Jeon, Mi Yang (College of Nursing.Institute of Health Science, Gyeongsang National University)
  • 강애정 (창원경상국립대학교병원) ;
  • 이송희 (창원경상국립대학교병원) ;
  • 김녹범 (경상국립대학교병원 예방관리센터) ;
  • 전미양 (경상국립대학교 간호대학.건강과학연구원)
  • Received : 2022.10.25
  • Accepted : 2022.11.24
  • Published : 2022.11.30
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Abstract

Purpose: The purpose of this study was to identify the factors affecting readmission in stroke patients. Methods: A retrospective study design was used. Participants were 3,675 adult cerebral stroke patients in the inpatient wards of the Department of Neurology and Neurosurgery of G University Hospital located in C city. Data were collected from January 1, 2016 to December 31, 2021 and data were analyzed using χ2 test, independent t-test, and multivariate logistic regression with SPSS/WIN 24.0. Results: After discharge for stroke, the readmission rate was 23.7%, and the mortality rate was 0.3%. The variables with significant differences between the readmission group and non-readmission group were age, type of stroke, surgery, ICU treatment, mRS score, blood pressure, diabetes, and heart disease. Factors influencing an readmission in stroke patients were Age 65-74 (OR 1.30, 95% CI=1.03-1.64), ≥ 75 (OR 1.28, 95% CI=1.02-1.62), mRS score 2points (OR 2.50, 95% CI=1.99-3.13), HTN status (OR 1.26, 95% CI=1.07-1.50), CVD status (OR 1.38, 95% CI=1.01-1.90), TC (OR 1.60, 95% CI=1.05-2.44). Conclusion: To lower the readmission rate of stroke patients, it is essential to control lifestyle, including whether or not to take treatment drugs, after diagnosing risk factors such as high blood pressure, diabetes, and heart disease, hyperlipidemia. Nursing interventions that can provide information on risk factor management and coping strategies are urgently needed as symptoms change. In addition, research is needed to develop and implement an intervention strategy that can improve the function of stroke patients as much as possible at home or in society so that they can lead an independent life without the help of others, and verify their effectiveness.

Keywords

Acknowledgement

본 논문은 2022년도 한국기초간호학회의 연구비 지원에 의하여 이루어졌음.

References

  1. World Health Organization. Stroke-1989. Recommendations on stroke prevention, diagnosis, and therapy. Special report. 1989;20(10):1407-1431. https://doi.org/10.1161/01.str.20.10.1407
  2. Statistics Korea. Cause of death statistics [Internet]. Daejeon: Statistics Korea; 2021 [cited 2022 Sept 25]. Available from: https://www.index.go.kr/potal/stts/idxMain/selectPoSttsIdxSearch.do?idx_cd=1012&stts_cd=101201&freq=Y
  3. World Health Organization. The top 10 causes of death [Internet]. Geneva: World health organization; 2020 [cited 2022 Sept 25]. Available from : https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
  4. Kim JY, Kang KS, Kang JH, Koo JS, Kim DH, Kim BJ, et al. Executive summary of stroke statistics in Korea 2018: a report from the epidemiology research council of the Korean Stroke Society. Journal of Stroke. 2019;21(1):42-59. https://doi.org/10.5853/jos.2018.03125
  5. Kim EJ, Kong JH. The effects of primary stroke prevention program on the knowledge of stroke, stroke symptom coping behavior and self management of stroke risk group. Journal of the Korea Academia-Industrial Cooperation Society. 2015;16(11):7925-7933. http://dx.doi.org/10.5762/KAIS.2015.16.11.7925
  6. Bae SG, Lee SK, Han CH. Influencing and mediating factors in stroke: based on 2007-2012 Korea National Health and Nutrition. Journal of the Korea Academia-Industrial cooperation Society. 2015;16(11):7925-7933. http://dx.doi.org/10.5762/KAIS.2015.16.11.7925
  7. Kim JY, Na YK, Hong HS. The effects of a secondary stroke prevention program on the health risk indicators and self care compliance of stroke patients. Journal of Korean Biological Nursing Science. 2016;18(2):69-77. http://dx.doi.org/10.7586/jkbns.2016.18.2.69
  8. Sunnerhagen KS, Svantesson U, Lonn L, Krotkiewski M, Grimby G. Upper motor neuron lesions: their effect on muscle performance and appearance in stroke patients with minor motor impairment. Archives of Physicalmedicine and Rehabilitation. 1999;80(2):155-161. https://doi.org/10.1016/S0003-9993(99)90113-2
  9. Sunnerhagen KS. Circuit training in community-living "younger" men after stroke. Journal of Stroke and Cerebrovascular Diseases. 2007;16(3):122-129. https://doi.org/10.1016/j.jstrokecerebrovasdis.2006.12.003
  10. Camicioli R, Panzer VP, Kaye J. Balance in the healthy elderly: posturography and clinical assessment. Archives of Neurology. 1997;54(8):976-981. https://doi.org/10.1001/archneur.1997.00550200040008
  11. Granger CV, Albrecht GL, Hamilton BB. Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the barthel index. Archives of Physical Medicine and Rehabilitation. 1979;60(4):145-154. https://doi.org/10.3109/03790798509166114
  12. Park AS, Ko E. Influences of rehabilitation motivation, self-efficacy and family support on rehabilitation adherence in stroke patients. Journal of Korean Biological Nursing Science. 2017;19(2):113-122. https://doi.org/10.7586/jkbns.2017.19.2.113
  13. Agarwal V, McRae MP, Bhardwaj A, Teasell RW. A model to aid in the prediction of discharge location for stroke rehabilitation patients. Archives of Physical Medicine and Rehabilitation. 2003;84(11):1703-1709. https://doi.org/10.1053/s0003-9993(03)00362-9
  14. Kim EK. Follow-up study in rehospitalization of stroke rehabilitation patients [master's thesis]. Seoul: Yonsei University; 2007. p. 10-29.
  15. Jun SY, Ju HJ, Yu JS, Lee JH. A prediction model for the resilience and the quality of life in cancer patients with radiotherapy. Asian Oncology Nursing. 2015;15(4):228-238. http://dx.doi.org/10.5388/aon.2015.15.4.228
  16. Smith DM, Giobbie HA, Weinberger M, Oddone EZ, Henderson WG, Asch DA, et al. Predicting non-elective hospital readmissions: a multi-site study. Journal of Clinical Epidemiology. 2000;53(11):1113-1118. https://doi.org/10.1016/s0895-4356(00)00236-5
  17. Jasti H, Mortensen EM, Obrosky DS, Kapoor WN, Fine MJ. Causes and risk factors for rehospitalization of patients hospitalized with community-acquired pneumonia. Clinical Infectious Diseases. 2008;46(4):550-556. https://doi.org/10.1086/526526
  18. Silverstein MD, Qin H, Mercer SQ, Fong J, Haydar Z. Risk factors for 30-day hospital readmission in patients ≥65 years of age. Proceedings (Baylor University. Medical Center). 2008;21(4):363-372. https://doi.org/10.1080/08998280.2008.11928429
  19. Reed RL, Pearlman RA, Buchner DM. Risk factors for early unplanned hospital readmission in the elderly. Journal of General Internal Medicine. 1991;6(3):223-228. https://doi.org/10.1007/BF02598964
  20. Corrigan JM, Martin JB. Identification of factors associated with hospital readmission and development of a predictive model. Health Services Research. 1992;27(1):81-101.
  21. Llody DH, Miles DW. Causes and correlates of 30 day and 180 day readmission following discharge from a medicine for the elderly rehabilitation unit. BMC geriatrics. 2018;18(1):1-10. https://doi.org/10.1186/s12877-018-0883-3
  22. Wilson JL, Hareendran A, Hendry A, Potter J, Bone L, Muir KW. Reliability of the modified rankin scale across multiple raters. Stroke. 2005;36(4):777-781. https://doi.org/10.1161/01.STR.0000157596.13234.95
  23. Clinical Research Center for Stroke. Clinical practice guidelines for stroke [Internet]. Seoul: Clinical Research Center for Stroke; 2020 [cited 2022 Sept 25]. Available from: http://www.stroke-crc.or.kr.
  24. Korean Society for the Study of Obesity. Clinical practice guideline for obesity [Internet]. Seoul: Korean Society for the Study of Obesity; 2020 [cited 2022 Sept 25]. Available from: http://general.kosso.or.kr/html/
  25. Chuang KY, Wu SC, Ma AHS, Chen YH, Wu CL. Identifying factors associated with hospital readmissions among stroke patients in Taipei. Journal of Nursing Research. 2005;13(2):117-128. https://doi.org/10.1097/01.jnr.0000387533.07395.42
  26. Bjerkreim AT, Thomassen L, Brogger J, Waje-Andreassen U, Naess H. Causes and predictors for hospital readmission after ischemic stroke. Journal of Stroke and Cerebrovascular Diseases. 2005;24(9):2095-2101. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.05.019
  27. Jeon MY, Cho HJ, Park MG, Jin MJ, Ha YM. A Comparative study on risk factors related to patient with recurrent stroke between recurrent group and non-recurrent group: single hospital based cohort study. Journal of Muscle and Joint Health. 2020;27(3):219-228. https://doi.org/10.5953/JMJH.2020.27.3.219
  28. Kim MO, Kim KY. The Factors influencing selection for rehabilitation hospital after stroke. Journal of Health Informatics and Statistics. 2022;47(1):9-19. https://doi.org/10.21032/jhis.2022.47.1.9
  29. Kim JH, Lee HJ, Lee SW, Park MS. Measures to improve the number of nursing hospitals. Research report. Gangwon-do: Health Insurance Review & Assessment Service; 2015 Feb.
  30. Lee KB, Lim JY, Kim WH, Jang SJ, Kim BS, Hyu AN, et al. Utilization status of public health and medical rehabilitation services by the persons with disabilities in community. Annals of Rehabilitation Medicine. 2004;28(2):175-181.
  31. World Health Oraganization. Community-based rehabilitation: CBR Guidelines [Internet]. Geneva: World health organization; 2010 [cited 2022 Nov 10]. Available from: https://apps.who.int/iris/handle/10665/44405
  32. Ministry of Health and Welfare. 2019 Ministry of Health and Welfare White Book. Report. Sejong: Ministry of Health and Welfare; 2020 Sept. Report No.: 11-1352000-000160-10.
  33. Kim HS. Risk of stroke according to the duration of diabetes mellitus with hypertension. Korean Journal of Clinical Laboratory Science. 2020;52(3):188-193. https://doi.org/10.15324/kjcls.2020.52.3.188
  34. Judith HL, Erica CL, Sara BJ, Yun W, Larry BG. Preventable readmissions within 30 days of ischemic stroke among medicare beneficiaries. Stroke. 2013;44: 3429-3435. https://doi.org/10.1161/STROKEAHA.113.003165
  35. Kim MK, Han KD, Kim HS, Park YM, Kwon HS, Yoon KH, et al. Cholesterol variability and the risk of mortality, myocardial infarction, and stroke: a nationwide population-based study. European Heart Journal. 2017;38(48):3560-3566. https://doi.org/10.1093/eurheartj/ehx585
  36. Sacco RL, Shi T, Zamanillo MC, Kargman DE. Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan stroke study. Neurology. 1994;44(4):626-634. https://doi.org/10.1212/WNL.44.4.626
  37. Petty GW, Brown RD, Whisnant JP, Sicks JD, O'Fallon WM, Wiebers DO. Survival and recurrence after first cerebral infarction: a population-based study in Rochester, Minnesota, 1975 through 1989. Neurology. 1998;50(1):208-216. https://doi.org/10.1212/wnl.50.1.208