Risk of 28-day readmissions among stroke patients in Malaysia (2008-2015): Trends, causes and its associated factors

Risk of readmissions is an important quality indicator for stroke care. Such information is limited among low- and middle-income countries. We assessed the trends for 28-day readmissions after a stroke in Malaysia from 2008 to 2015 and evaluated the causes and factors associated with readmissions in...

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Bibliographic Details
Published in:PloS one 2021-01, Vol.16 (1), p.e0245448-e0245448
Main Authors: Ang, Swee Hung, Hwong, Wen Yea, Bots, Michiel L, Sivasampu, Sheamini, Abdul Aziz, Aznida Firzah, Hoo, Fan Kee, Vaartjes, Ilonca
Format: Article
Language:English
Subjects:
Age
Care and treatment
Data analysis
Data base management systems
Editing
Ethics
Ethnicity
Flow charts
Health care
Health care facilities
Health risks
Health sciences
Hospital care
Hospitals
Information management
Informed consent
Medical research
Medicine
Medicine and Health Sciences
Morbidity
Neurology
Patients
People and Places
Preventive medicine
Primary care
Research ethics
Risk factors
Sexes
Statistics
Stroke
Stroke (Disease)
Trends
Womens health
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Summary:Risk of readmissions is an important quality indicator for stroke care. Such information is limited among low- and middle-income countries. We assessed the trends for 28-day readmissions after a stroke in Malaysia from 2008 to 2015 and evaluated the causes and factors associated with readmissions in 2015. Using the national hospital admission records database, we included all stroke patients who were discharged alive between 2008 and 2015 for this secondary data analysis. The risk of readmissions was described in proportion and trends. Reasons were coded according to the International Classification of Diseases, 10th Edition. Multivariable logistic regression was performed to identify factors associated with readmissions. Among 151729 patients, 11 to 13% were readmitted within 28 days post-discharge from their stroke events each year. The trend was constant for ischemic stroke but decreasing for hemorrhagic stroke. The leading causes for readmissions were recurrent stroke (32.1%), pneumonia (13.0%) and sepsis (4.8%). The risk of 28-day readmission was higher among those with stroke of hemorrhagic (adjusted odds ratio (AOR): 1.52) and subarachnoid hemorrhage (AOR: 2.56) subtypes, and length of index admission >3 days (AOR: 1.48), but lower among younger age groups of 35-64 (AORs: 0.61-0.75), p values
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0245448