Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke.

Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke. Research Abstract Details 

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Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke. Abstract Text:

Amy J H Kind,Maureen A Smith,Jennifer R Frytak,Michael D Finch,Amy J H Kind,Maureen A Smith,Jennifer R Frytak,Michael D Finch,

OBJECTIVES: To identify predictors of complicated transitions within 30 days after discharge from hospitalization for acute stroke. DESIGN: Retrospective analysis of administrative data. SETTING: Four hundred twenty-two hospitals in the southern and eastern United States. PARTICIPANTS: Thirty-nine thousand three hundred eighty-four Medicare beneficiaries aged 65 and older discharged after acute ischemic stroke from 1998 to 2000. MEASUREMENTS: Complicated transition, defined as movement from less- to more-intensive care setting after hospital discharge, with hospital being most intensive and home without home health care being least intensive. RESULTS: Twenty percent of patients experienced at least one complicated transition; 16% of those experienced more than one complicated transition. After adjustment using logistic regression, factors predicting any complicated transition included older age, African-American race, Medicaid enrollment, prior hospitalization, gastrostomy tube, chronic disease, length of stay, and discharge site. Patients with multiple complicated transitions were more likely to be African American (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.13-1.68), be male (OR=1.21, 95% CI=1.04-1.40), have a prior diagnosis of fluid and electrolyte disorder (e.g., dehydration) (OR=1.23, 95% CI=1.07-1.43), have a prior hospitalization (OR=1.18, 95% CI=1.01-1.36), and be initially discharged to a skilled-nursing facility or long-term care (OR=1.22, 95% CI=1.04-1.44) than patients with only one complicated transition. They were less likely to be initially discharged to a rehabilitation center (OR=0.71, 95% CI=0.57-0.89). CONCLUSION: Significant numbers of stroke patients experience complicated transitions soon after hospital discharge. Sociodemographic factors and initial discharge site distinguish patients with multiple complicated transitions. These factors may enable prospective identification and targeting of stroke patients at risk for "bouncing back."

Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke. Publishing Authors By Initials

AJ Kind,MA Smith,JR Frytak,MD Finch,AJ Kind,MA Smith,JR Frytak,MD Finch,

For similar geographic locations: americas: north america: united states research abstracts see: geographic locations: americas: north america: united states research

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Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Journal of the American Geriatrics Society

VOLUME: 55

Page Numbers: 365-73

Journal Abbreviation:

ISSN: 0002-8614

DAY: 3

MONTH: Mar

YEAR: 2007

Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke. Information

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LANGUAGE: eng

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Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke. Keywords Mesh Terms:

KEYWORDS: United States

MESH TERMS: statistics & numerical data

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Grant and Affiliation Information for Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke.

AFFILIATION: Department of Population Health Sciences, Wisconsin, Madison, Wisconsin, WI 53705, USA. ajk@medicine.wisc.edu

Country: United States

AGENCY: United States NIA

GRANT: R01-AG19747

ACRONYM: AG

MEDLINETA: J Am Geriatr Soc

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