Infection During a Stroke Hospitalization Increases the Risk for Readmission

Patients who experience a common infection, such as a urinary tract infection, during their hospital stay for a stroke are 21% more likely to be readmitted than patients without an infection, according to new research.

“Hospital readmissions, particularly within the first 30 days after discharge, can contribute to morbidity and mortality. Identifying risk factors for a readmission within 30 days of discharge is particularly important,” said Amelia K. Boehme, PhD, the study’s lead author and assistant professor of epidemiology in neurology for Vagelos College of Physicians and Surgeons at Columbia University in New York City.

To conduct their study, Dr Boehme and colleagues assessed patient data from the 2013 National Readmission Database. ICD-9 diagnosis codes were used to identify ischemic stroke; common infections including sepsis, pneumonia, and urinary tract infection; and comorbidities.

Dr Boehme and colleagues identified 319,317 patients with ischemic stroke. Of whom, 12% were readmitted within 30 days, and 29% had had an infection during their initial hospital stay.

Overall, participants with any type of infection were 21% more likely to be readmitted within 30 days than participants without an infection.

“People who have an infection during their stroke stay might need different post-stroke follow-up than people without an infection during their stroke stay,” Dr Boehme said.

In adjusted models, only urinary tract infections were associated with 30-day readmission.

“Infections during a stroke hospitalization are associated with many different poor short-term outcomes, including increasing the risk of 30-day readmissions. This at-risk patient population might benefit from tailored follow-up after discharge to include primary care, neurology, and infectious disease specialists,” Dr Boehme concluded.

—Amanda Balbi

Reference:

Boehme AK, Kulick ER, Canning M, et al. Infections increase the risk of 30-day readmissions among stroke survivors: analysis of the National Readmission Database. Stroke. 2018;49(12):2999-3005. https://doi.org/10.1161/STROKEAHA.118.022837.