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The effect of 30-day adequate transitions of acute stroke care on 90-day readmission or death.
Johnson, Karlon H; Gardener, Hannah; Gutierrez, Carolina; Marulanda, Erika; Campo-Bustillo, Iszet; Gordon Perue, Gillian; Brown, Scott C; Ying, Hao; Zhou, Lili; Bishop, Lauri; Veledar, Emir; Fakoori, Farya; Asdaghi, Negar; Romano, Jose G; Rundek, Tatjana.
Afiliación
  • Johnson KH; Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, FL 33136, USA. Electronic address: khj12@miami.edu.
  • Gardener H; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Gutierrez C; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Marulanda E; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Campo-Bustillo I; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Gordon Perue G; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Brown SC; Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, FL 33136, USA.
  • Ying H; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Zhou L; Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, FL 33136, USA.
  • Bishop L; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Veledar E; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Fakoori F; Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, FL 33136, USA.
  • Asdaghi N; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Romano JG; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
  • Rundek T; Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th St. #609 Miami, FL 33136, USA.
J Stroke Cerebrovasc Dis ; 33(9): 107842, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38955245
ABSTRACT

OBJECTIVES:

We explore patient-reported behaviors and activities within 30-days post-stroke hospitalization and their role in reducing death or readmissions within 90-days post-stroke.

METHODS:

We constructed the adequate transitions of care (ATOC) composite score, measuring patient-reported participation in eligible behaviors and activities (diet modification, weekly exercise, follow-up medical appointment attendance, medication adherence, therapy use, and toxic habit cessation) within 30 days post-stroke hospital discharge. We analyzed ATOC scores in ischemic and intracerebral hemorrhage stroke patients discharged from the hospital to home or rehabilitation facilities and enrolled in the NIH-funded Transitions of Care Stroke Disparities Study (TCSD-S). We utilized Cox regression analysis, with the progressive adjustment for sociodemographic variables, social determinants of health, and stroke risk factors, to determine the associations between ATOC score within 30-days and death or readmission within 90-days post-stroke.

RESULTS:

In our sample of 1239 stroke patients (mean age 64 +/- 14, 58 % male, 22 % Hispanic, 22 % Black, 52 % White, 76 % discharged home), 13 % experienced a readmission or death within 90 days (3 deaths, 160 readmissions, 3 readmissions with subsequent death). Seventy percent of participants accomplished a ≥75 % ATOC score. A 25 % increase in ATOC was associated with a respective 20 % (95 % CI 3-33 %) reduced risk of death or readmission within 90-days.

CONCLUSION:

ATOC represents modifiable behaviors and activities within 30-days post-stroke that are associated with reduced risk of death or readmission within 90-days post-stroke. The ATOC score should be validated in other populations, but it can serve as a tool for improving transitions of stroke care initiatives and interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Readmisión del Paciente Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Readmisión del Paciente Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos