Systematic Reviews of Hospital Readmission Risk Screening: Reflective Case Study of Older Adults with Stroke

Authors

  • Jantra Keawpugdee Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
  • Plernpit Boonyamalik Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
  • Pimpan Silpasuwan Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
  • Chukiat Viwatwongkasem Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
  • Ainat Koren Susan and Alan Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, USA

DOI:

https://doi.org/10.48048/tis.2022.2048

Keywords:

Stroke, Hospital readmission, Systematic reviews, Case report, Screening tool

Abstract

Stroke remains a leading cause of death and disability, with older adults disproportionately affected. This study aimed to investigate stroke patients’ short- and long-term readmissions to develop a new readmission risk screening tool (RRST) by conducting a systematic review and examining reflective cases reported to validate screening applications. Methods: A comprehensive search was conducted on 4 databases; eligible systematic reviews via CINAHL, MEDLINE/PubMed, Ovid UML, and Cochrane Library, with 14 research articles emerging to be content extracted as the 1st draft. Expert opinion assessed findings, then revised them to develop a new RRST draft and checked it with a reflective quality check of 4 selected, screened cases. The review identified 14 studies using 5 screening tools. ISAR, TRST, and HOSPITAL score showed low to moderate validity and moderate to good reliability. The Risk Readmission Assessment Tool (RRAT) and LACE index validity and reliability scores were low to moderate. Hospital readmission predictors were hospital admission history, polypharmacy, cognitive and memory problems, the need for help, difficulties in walking, length of stay, and comorbid conditions. The 4 cases reported reflecting the developed RRST screening showed all common features. Value-added, the new RRST could accurately predict high-risk hospital readmission groups; the extended RRST tool screening quality is to be verified in clinical and community trials.

HIGHLIGHTS

  • This study aimed to identify and assess the stroke risk screening on the stroke elderly patients before hospital discharge to home by exploring and synthesizing with systematic reviews and reflecting the practicability and efficacy of new screening tool. The finding that effectively constructed risk screening tools of hospital readmission among the stroke elderly is a development of unplanned hospital readmission risk detection in a practical way for Thai stroke patients might be of significant added value.

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References

VL Feigin, MH Forouzanfar, R Krishnamurthi, GA Mensah, M Connor, DA Bennett, AE Moran, RL Sacco, L Anderson, T Truelsen, M O'Donnell, N Venketasubramanian, S Barker-Collo, CMM Lawes, W Wang, Y Shinohara, E Witt, M Ezzati, M Naghavi and C Murray. Global and regional burden of stroke during 1990 - 2010: Findings from the Global Burden of Disease Study 2010. Lancet 2014; 383, 245-54.

MI Khan, JI Khan, SI Ahmed and U Haq. The epidemiology of stroke in a developing country (Pakistan). J. Neurol. Stroke 2018; 8, 00275.

C Franchi, A Nobili, D Mari, D Mari, M Tettamanti, CD Djade, L Pasina, F Salerno, S Corrao, A Marengoni, A Iorio, M Marcucci and PM Mannucci. Risk factors for hospital readmission of elderly patients. Eur. J. Intern. Med. 2013; 24, 45-51.

MF Kilkenny, M Longworth, M Pollack, C Levi and DA Cadilhac. Factors associated with 28-day hospital readmission after stroke in Australia. Stroke 2013; 44, 2260-8.

JP Bettger, B Lupo, K Nichols, K Smith, E Windes and T Darden-Fluker. Hospital readmission among stroke patients who received post-hospital care: A systematic review. Int. J. Phys. Med. Rehabil. 2013; 1, 137.

ML Barnett, J Hsu and JM McWilliams. Patient characteristics and differences in hospital readmission rates. JAMA Intern. Med. 2015; 175, 1803-12.

D Moher, A Liberati, J Tetzlaff, and D Altman. Preferred Reporting items for systematic reviews and meta-analyess: The PRISMA statement. PLoS Med. 2009; 6, e1000097.

R Farzanegan, B Farzanegan, M Alehashem, M Zangi, SRN Kalhori, K Sheikhy, H Emami and MB Shadmehr. Item selection and content validity of the risk factors of post-intubation tracheal stenosis observation questionnaire for ICU-admitted patients. Tanaffos 2017; 16, 22-33.

CE Graf, SV Giannelli, FR Herrmann, FP Sarasin, JP Michef, D Zekry and T Chevalley. Identification of older patients at risk of unplanned readmission after discharge from the emergency department - comparison of two screening tools. Swiss Med. Wkly 2012; 141, w13327.

T Braes, P Moons, P Lipkens, W Sterckx, M Sabbe, J Flammaing, S Boonen and K Milisen. Screening for risk of unplanned readmission in older patients admitted to hospital: Predictive accuracy of three instruments. Aging Clin. Exp. Res. 2010; 22, 345-51.

P Moons, KD Ridder, K Geyskens, M Sabbe, T Braes, J Flamaing and K Milisen. Screening for risk of readmission of patients aged 65 years and above after discharge from the emergency department: Predictive value of four instruments. Eur. J. Emerg. Med. 2007; 14, 315-23.

JD Donze, MV Williams, EJ Robinson, E Zimlichman, D Aujesky, EE Vasilevskis, S Kripalani, JP Metlay, GS Fletcher, AD Auerbach and JL Schnipper. Internal validity of the HOSPITAL score to predict 30-day potentially avoidable hospital readmissions. JAMA Inter. Med. 2016; 176, 496-502.

T Fasolino and M Phillips. Utilizing risk readmission assessment tool for nonhospice palliative care consults in heart failure patients. J. Palliat. Med. 2016; 19, 1098-101.

R Robinson. The HOSPITAL score as a predictor of 30 day readmission in a retrospective study at a university affiliated community hospital. PeerJ 2016; 4, e2441.

S Boraiah, L Joo, IA Inneh, P Rathod, M Meftah, P Band, JA Bosco and R Iorio. Management of modifiable risk factors prior to primary hip and knee arthroplasty: A readmission risk assessment tool. J. Bone Joint Surg. Am. 2015; 97, 1921-8.

E Rosted, M Schultz, H Dynesen, M Dahl, M Sqrensen and S Sanders. The identification of seniors at risk screening tool is useful for predicting acute readmissions. Dan. Med. J. 2014; 61, A4828.

K Singler, HJ Heppner, A Skutetzky, C Sieber, M Christ and U Thiem. Predictive validity of the identification of seniors at risk screening tool in a German emergency department setting. Gerontology 2014; 60, 413-9.

JS Lee, G Schwindt, M Langevin, R Moghaghab, SMH Alibhai, A Kiss and G Naglie. Validation of the triage risk stratification tool to identify older persons at risk for hospital admission and returning to the emergency department. J. Am. Geriatr. Soc. 2008; 56, 2112-7.

SW Meldon, LC Mion, RM Palmer, BL Drew, JT Connor, LJ Lewicki, DM Bass and CL Emerman. A brief risk-stratification tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department. Acad. Emerg. Med. 2003; 10, 224-32.

M Simpson. A quality improvement plan to reduce 30-day readmissions of heart failure patients. J. Nurs. Care Qual. 2014; 29, 280-6.

J Edmans, L Bradshaw, JRF Gladman, M Franklin, V Berdunov, R Elliott and SP Conroy. The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units. Age Aging 2013; 42, 747-53.

CV Walraven, IA Dhalla, C Bell, E Etchells, IG Stiell, K Zarnke, PC Austin and AJ Forster. Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Can. Med. Assoc. J. 2010; 182, 551-7.

N Burns and S Grove. The practice of nursing research: Conduct, critique and utilization. 4th eds. W.B. Saunders, Philadelphia, Pennsylvania, 2001.

DE Hinkle, W Wiersma and SG Jurs. Applied statistics for the behavioral sciences. 5th eds. Houghton Mifflin, Boston, MA, 2003.

A Kumar. Review of the step for development of quantitative research tools. J. Adv. Practices Nurs. 2015; 1, 103.

JL Yao, J Fang, QQ Lou and RM Anderson. A systematic review of the identification of seniors at risk (ISAR) tool for the prediction of adverse outcomes in elderly patients seen in the emergency department. Int. J. Clin. Exp. Med. 2015; 8, 4778-86.

JR Vest, DL Gamm, BA Oxford, MI Gonzalez and KM Slawson. Determinants of preventable readmissions in the United States: A systematic review. Implement. Sci. 2010; 5, 88.

C Qin, H Minghan, Z Ziwen and L Yukun. Alteration of lipid profile and value of lipids in the prediction of the length of hospital stay in COVID‐19 pneumonia patients. Food Sci. Nutr. 2020; 8, 6144-52.

N Lorking, AD Wood, S Tiamkao, AB Clark, K Kongbunkiat, JH Bettencourt-Silva, K Sawanyawisuth, N Kasemsap, MA Mamas and PK Myint. Seasonality of stroke: Winter admissions and mortality excess: A Thailand National Stroke population database study. Clin. Neurol. Neurosurg. 2020; 199, 106261.

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Published

2022-01-15

How to Cite

Keawpugdee, J. ., Boonyamalik, P. ., Silpasuwan, P. ., Viwatwongkasem, C. ., & Koren, A. . (2022). Systematic Reviews of Hospital Readmission Risk Screening: Reflective Case Study of Older Adults with Stroke. Trends in Sciences, 19(2), 2048. https://doi.org/10.48048/tis.2022.2048