Background
Methods
Results
Demographics of individuals with an incident hospitalisation for stroke and risk of readmission
Total
|
Not Readmitted
|
Readmitted
|
% readmitted
| |
---|---|---|---|---|
(n = 51182)
|
(n = 43435)
|
(n = 7747)
|
(overall 15.1)
| |
Age group (years):
| ||||
<55
| 6909 (13.5) | 6294 (14.5) | 615 (7.9) | 8.9 |
55 – 64
| 8238 (16.1) | 7293 (16.8) | 945 (12.2) | 11.5 |
65 – 74
| 13909 (27.2) | 11832 (27.2) | 2077 (26.8) | 14.9 |
75 – 84
| 15413 (30.1) | 12655 (29.1) | 2758 (35.6) | 17.9 |
85+
| 6713 (13.1) | 5361 (12.3) | 1352 (17.5) | 20.1 |
Sex:
| ||||
Men
| 24754 (48.4) | 21170 (48.7) | 3584 (46.3) | 14.5 |
Women
| 26428 (51.6) | 22265 (51.3) | 4163 (53.7) | 15.8 |
Socioeconomic status:
| ||||
1 (least deprived)
| 6805 (13.3) | 5855 (13.5) | 950 (12.3) | 14.0 |
2
| 8398 (16.4) | 7149 (16.5) | 1249 (16.1) | 14.9 |
3
| 10265 (20.1) | 8727 (20.0) | 1538 (19.8) | 15.0 |
4
| 11797 (23.1) | 9934 (22.8) | 1863 (24.1) | 15.8 |
5 (most deprived)
| 13060 (25.5) | 10942 (25.2) | 2118 (27.3) | 16.2 |
Missing
| 857 (1.7) | 828 (2.0) | 29 (0.4) | |
Comorbidity:
| ||||
No comorbidity
| 12724 (24.9) | 11432 (26.2) | 1292 (16.7) | 10.2 |
Diabetes
| 5946 (11.6) | 4862 (11.2) | 1084 (14.0) | 18.2 |
Cancer
| 3569 (7.0) | 2904 (6.7) | 665 (8.6) | 18.6 |
Respiratory disease
| 4270 (8.3) | 3338 (7.7) | 932 (12.3) | 21.8 |
Heart failure
| 3321 (6.5) | 2570 (5.9) | 751 (9.7) | 22.6 |
Peripheral arterial disease
| 3078 (6.0) | 2492 (5.7) | 586 (7.6) | 19.0 |
Atrial fibrillation
| 7429 (14.5) | 6145 (14.1) | 1284 (16.6) | 17.3 |
Essential hypertension
| 15824 (30.9) | 13428 (30.9) | 2396 (30.9) | 15.1 |
Renal failure
| 1481 (2.9) | 1130 (2.6) | 351 (4.5) | 23.7 |
Coronary heart disease
| 10133 (19.8) | 8255 (19.0) | 1878 (24.2) | 18.5 |
Rheumatic/Valvular heart disease
| 1561 (3.1) | 1284 (2.9) | 277 (3.6) | 17.7 |
Depression
| 1261 (2.5) | 1023 (2.4) | 238 (7.1) | 18.9 |
Parkinsonism
| 493 (1.0) | 386 (1.0) | 107 (1.4) | 21.7 |
Dementia
| 1987 (3.9) | 1586 (3.7) | 401 (5.2) | 20.2 |
Alcohol misuse
| 2562 (5.0) | 2021 (4.7) | 541 (7.0) | 21.2 |
Infections
| 8609 (16.8) | 6675 (15.4) | 1934 (25.0) | 22.5 |
Immobility
| 8021 (15.7) | 6312 (14.5) | 1709 (22.1) | 21.3 |
Gastrointestinal
| 12527 (24.5) | 9715 (22.4) | 2812 (36.3) | 22.4 |
Discharge destination:
| ||||
Home
| 40129 (78.4) | 34057 (78.4) | 6072 (78.4) | 15.1 |
Care/Nursing
| 10225 (20.0) | 8712 (20.1) | 1513 (19.5) | 14.8 |
Other
| 183 (0.4) | 152 (0.3) | 31 (0.4) | 16.9 |
Missing
| 645 (1.3) | 514 (1.2) | 131 (1.6) | |
Length of stay (days):
| ||||
1 – 7
| 14100 (27.6) | 12519 (28.8) | 1581 (20.4) | 11.2 |
8 – 14
| 9047 (17.7) | 7735 (17.8) | 1312 (16.9) | 14.5 |
15 – 21
| 5248 (10.3) | 4434 (10.2) | 814 (10.5) | 15.5 |
22 – 28
| 3532 (6.9) | 2911 (6.7) | 621 (8.0) | 17.6 |
29+
| 19255 (37.6) | 15836 (36.5) | 3419 (44.1) | 17.8 |
Year of discharge:
| ||||
1997 – 1999
| 17083 (33.4) | 14602 (33.6) | 2481 (32.0) | 14.5 |
2000 – 2002
| 17648 (34.5) | 14954 (34.4) | 2694 (34.8) | 15.3 |
2003 – 2005
| 16451 (32.1) | 13879 (32.0) | 2572 (33.2) | 15.6 |
Cumulative incidence of readmission and death
Modelling of risk of readmission and death
Readmissions
|
Deaths
| |||
---|---|---|---|---|
Unadjusted HR (95% CI)
|
Adjusted HR (95% CI)
|
Unadjusted HR (95% CI)
|
Adjusted HR (95% CI)
| |
Age group (years):
| ||||
Age 55–64
| 1.31 (1.18-1.45) | 1.23 (1.11-1.36) | 1.70 (1.43-2.02) | 1.60 (1.35-1.90) |
Age 65–74
| 1.73 (1.58-1.90) | 1.58 (1.44-1.73) | 3.29 (2.84-3.82) | 2.52 (2.17-2.94) |
Age 75–84
| 2.11 (1.94-2.31) | 1.87 (1.71-2.05) | 6.17 (5.35-7.13) | 3.74 (3.23-4.34) |
Age 85+
| 2.43 (2.21-2.68) | 2.08 (1.87-2.31) | 11.20 (9.67-12.95) | 5.31 (4.55-6.19) |
Sex:
| ||||
Women
| 1.09 (1.05-1.15) | 1.02 (0.97-1.07) | 1.31 (1.25-1.38) | 0.95 (0.90-1.00) |
Socioeconomic status:
| ||||
2
| 1.07 (0.98-1.16) | 1.05 (0.96-1.14) | 1.12 (1.02-1.23) | 1.11 (1.01-1.22) |
3
| 1.07 (0.99-1.17) | 1.06 (0.97-1.15) | 1.10 (1.01-1.20) | 1.08 (0.99-1.19) |
4
| 1.14 (1.05-1.23) | 1.12 (1.03-1.21) | 1.06 (0.98-1.16) | 1.10 (1.01-1.20) |
5 (most deprived)
| 1.17 (1.09-1.27) | 1.16 (1.08-1.26) | 0.98 (0.90-1.07) | 1.16 (1.06-1.27) |
Year of discharge:
| ||||
Year 1998
| 1.03 (0.93-1.14) | 1.01 (0.91-1.11) | 1.04 (0.94-1.15) | 1.00 (0.90-1.11) |
Year 1999
| 1.01 (0.92-1.12) | 1.00 (0.90-1.10) | 0.96 (0.86-1.07) | 0.92 (0.83-1.03) |
Year 2000
| 1.05 (0.95-1.16) | 1.01 (0.91-1.12) | 0.93 (0.84-1.03) | 0.89 (0.80-0.99) |
Year 2001
| 1.11 (1.01-1.22) | 1.06 (0.96-1.17) | 0.97 (0.87-1.07) | 0.92 (0.82-1.02) |
Year 2002
| 1.05 (0.95-1.16) | 1.01 (0.92-1.12) | 0.88 (0.79-0.98) | 0.86 (0.77-0.96) |
Year 2003
| 1.14 (1.03-1.26) | 1.10 (0.99-1.21) | 0.90 (0.81-1.00) | 0.92 (0.82-1.03) |
Year 2004
| 1.10 (1.00-1.21) | 1.03 (0.93-1.14) | 0.89 (0.79-0.99) | 0.96 (0.85-1.07) |
Year 2005
| 1.06 (0.96-1.17) | 1.00 (0.90-1.11) | 0.89 (0.80-0.99) | 0.94 (0.83-1.05) |
Comorbidity:
| ||||
Diabetes
| 1.26 (1.18-1.34) | 1.17 (1.09-1.25) | 1.08 (1.00-1.16) | 1.11 (1.03-1.21) |
Cancer
| 1.28 (1.18-1.39) | 1.07 (0.98-1.16) | 2.60 (2.42-2.78) | 2.10 (1.95-2.27) |
Respiratory disease
| 1.57 (1.46-1.68) | 1.24 (1.15-1.33) | 1.19 (1.10-1.30) | 1.07 (0.98-1.17) |
Heart failure
| 1.63 (1.51-1.76) | 1.19 (1.10-1.30) | 2.07 (1.92-2.23) | 1.31 (1.20-1.43) |
Peripheral arterial disease
| 1.30 (1.20-1.42) | 1.08 (0.99-1.18) | 1.34 (1.22-1.47) | 1.27 (1.15-1.39) |
Atrial fibrillation
| 1.18 (1.11-1.26) | 0.92 (0.87-0.99) | 1.63 (1.53-1.73) | 1.16 (1.08-1.24) |
Essential hypertension
| 0.99 (0.95-1.04) | 0.91 (0.86-0.96) | 0.75 (0.71-0.79) | 0.79 (0.74-0.84) |
Renal failure
| 1.69 (1.52-1.89) | 1.23 (1.10-1.38) | 2.35 (2.12-2.61) | 1.67 (1.48-1.88) |
Coronary heart disease
| 1.32 (1.25-1.39) | 1.06 (1.00-1.12) | 1.28 (1.21-1.35) | 1.07 (1.00-1.15) |
Rheumatic/Valvular heart disease
| 1.20 (1.06-1.35) | 0.95 (0.83-1.08) | 1.38 (1.22-1.57) | 1.09 (0.95-1.24) |
Depression
| 1.29 (1.13-1.47) | 1.08 (0.94-1.23) | 1.18 (1.02-1.37) | 0.90 (0.77-1.06) |
Parkinsonism
| 1.50 (1.23-1.81) | 1.09 (0.89-1.33) | 2.75 (2.34-3.23) | 1.42 (1.19-1.69) |
Dementia
| 1.39 (1.26-1.54) | 1.06 (0.95-1.18) | 2.82 (2.59-3.07) | 1.26 (1.15-1.39) |
Alcohol misuse
| 1.47 (1.34-1.60) | 1.43 (1.30-1.57) | 0.75 (0.66-0.85) | 0.98 (0.85-1.12) |
Infections
| 1.74 (1.65-1.83) | 1.31 (1.24-1.38) | 1.92 (1.81-2.03) | 1.20 (1.13-1.28) |
Immobility
| 1.60 (1.51-1.69) | 1.23 (1.16-1.30) | 1.72 (1.62-1.82) | 1.01 (0.95-1.08) |
Gastrointestinal
| 1.86 (1.78-1.95) | 1.58 (1.51-1.66) | 1.33 (1.26-1.41) | 1.04 (0.99-1.11) |
Discharge destination:
| ||||
Care/Nursing
| 0.98 (0.92-1.03) | 0.73 (0.69-0.78) | 5.23 (4.98-5.50) | 3.75 (3.54-3.97) |
Other
| 1.14 (0.80-1.64) | 0.94 (0.65-1.36) | 3.82 (2.83-5.15) | 3.12 (2.29-4.25) |
Length of stay (days):
| ||||
LOS 8-14
| 1.31 (1.22.1.41) | 1.20 (1.11-1.29) | 1.18 (1.08-1.30) | 0.92 (0.83-1.01) |
LOS 15-21
| 1.42 (1.30-1.55) | 1.23 (1.13-1.34) | 1.57 (1.42-1.74) | 1.02 (0.92-1.14) |
LOS 22-28
| 1.62 (1.48-1.78) | 1.37 (1.24-1.51) | 1.86 (1.67-2.08) | 1.06 (0.94-1.18) |
LOS 29+
| 1.64 (1.55-1.74) | 1.41 (1.32-1.50) | 2.52 (2.36-2.71) | 1.10 (1.02-1.19) |