From the Guidelines
The average number of hospitalization days for patients readmitted between 3 months and 1 year after stroke is not explicitly stated in the provided evidence, but based on general knowledge, it can be estimated to be around 5-7 days. This duration varies based on several factors including stroke severity, comorbidities, and complications requiring treatment, as highlighted in the care of patients with acute ischemic stroke 1. Patients with more severe initial strokes, multiple comorbidities (such as diabetes, hypertension, or atrial fibrillation), or those who develop complications like pneumonia or urinary tract infections typically require longer stays.
Factors Influencing Readmission
- Stroke severity: Patients with more severe strokes are more likely to experience longer hospital stays and require more intensive care.
- Comorbidities: Presence of conditions like diabetes, hypertension, or atrial fibrillation can complicate recovery and prolong hospitalization.
- Complications: Development of complications such as pneumonia, urinary tract infections, or recurrent strokes can significantly extend the duration of hospital stay.
The readmission period of 3 months to 1 year represents a critical window when patients may experience recurrent strokes or complications from their initial event, emphasizing the need for comprehensive care and secondary prevention strategies, as suggested by the American Heart Association 1. During these readmissions, patients typically undergo diagnostic workup to identify stroke etiology if not previously determined, medication adjustments, and rehabilitation assessments. Healthcare providers should focus on optimizing secondary stroke prevention during this period, including antiplatelet or anticoagulation therapy as appropriate, blood pressure management, lipid control, and lifestyle modifications to reduce the likelihood of subsequent readmissions and to improve long-term outcomes.
From the Research
Average Number of Hospitalization Days at Readmission
- The average number of hospitalization days at readmission from 3 months to 1 year after stroke is not directly stated in the provided studies 2, 3, 4, 5, 6.
Readmission Rates and Causes
- Readmission rates after stroke are high, with 9.7% of patients readmitted within 30 days and 30.5% readmitted at 1 year following initial discharge 2.
- The most common causes of readmissions are stroke and post-stroke sequelae, followed by sepsis and acute renal failure 2.
- Infections, recurrent ischemic stroke, other cardiovascular events, and events related to index stroke are also common causes of readmission 3.
Factors Associated with Readmission
- Patients at increased risk of readmission are older, have longer initial lengths of stay, and have modifiable comorbidities such as vascular risk factors, depression, epilepsy, and drug abuse 2.
- Social determinants associated with increased readmission include living in an urban setting, living in zip-codes with the lowest median income, and having Medicare insurance 2.
- Early readmission is associated with older age, impaired physical function, atherosclerotic etiology of index stroke, and a higher risk factor burden 3.
- Late readmission is associated with older age and prior myocardial infarction 3.