1.Factors Affecting Readmission After Discharge in Stroke Patients: A Retrospective Study
Ae Jeong KANG ; Song Hee LEE ; Rock Beum KIM ; Mi Yang JEON
Journal of Korean Biological Nursing Science 2022;24(4):262-271
Purpose:
The purpose of this study was to identify the factors affecting readmission in stroke patients.
Methods:
A retrospective study design was used. Participants were 3,675 adult cerebral stroke patients in the inpatient wards of the Department of Neurology and Neurosurgery of G University Hospital located in C city. Data were collected from January 1, 2016 to December 31, 2021 and data were analyzed using χ2 test, independent t-test, and multivariate logistic regression with SPSS/WIN 24.0.
Results:
After discharge for stroke, the readmission rate was 23.7%, and the mortality rate was 0.3%. The variables with significant differences between the readmission group and non-readmission group were age, type of stroke, surgery, ICU treatment, mRS score, blood pressure, diabetes, and heart disease. Factors influencing an readmission in stroke patients were Age 65-74 (OR 1.30, 95% CI = 1.03-1.64), ≥ 75 (OR 1.28, 95% CI = 1.02-1.62), mRS score 2points (OR 2.50, 95% CI = 1.99-3.13), HTN status (OR 1.26, 95% CI = 1.07-1.50), CVD status (OR 1.38, 95% CI = 1.01-1.90), TC (OR 1.60, 95% CI = 1.05-2.44).
Conclusion
To lower the readmission rate of stroke patients, it is essential to control lifestyle, including whether or not to take treatment drugs, after diagnosing risk factors such as high blood pressure, diabetes, and heart disease, hyperlipidemia. Nursing interventions that can provide information on risk factor management and coping strategies are urgently needed as symptoms change. In addition, research is needed to develop and implement an intervention strategy that can improve the function of stroke patients as much as possible at home or in society so that they can lead an independent life without the help of others, and verify their effectiveness.
2.Incidence and Mortality of Osteoporotic Refractures in Korea according to Nationwide Claims Data
Jun Il YOO ; Yong Chan HA ; Ki Soo PARK ; Rock Beum KIM ; Sung Hyo SEO ; Kyung Hoi KOO
Yonsei Medical Journal 2019;60(10):969-975
PURPOSE: Studies on the incidence and mortality of refractures after primary osteoporotic fracture are limited by the relatively rare incidence of such refractures and small sample sizes. The objectives of this research were: 1) to determine the incidence of osteoporotic refractures and fracture locations and 2) to assess mortality rates associated with osteoporotic refracture over a median follow up of 3 years using nationwide claim database. MATERIALS AND METHODS: Patients over 50 years of age who had an osteoporotic fracture that was confirmed operationally were enrolled. Refracture was defined as that after 6 months of an untreated period. Mortality rate was calculated using the Charlson comorbidity index and was analyzed using Cox proportional hazards regression analysis. RESULTS: A total of 18956 first-time instances of osteoporotic fracture were reported between 2007 and 2012 after a median follow up of 3.1 years (range, 1 to 7 years). Among 18956 patients, 2941 (15.50%) experienced refracture. After follow up for 1 year, cumulative mortality rates for re-fracture and non-refracture groups were 9.1% and 7.2%, respectively. After adjusting for covriates, mortality rate was 1.2 times greater in patients with re-fracture than in patients without re-fracture over a median follow up of 3 years (hazard ratio: 1.20, 95% confidence interval: 1.08–1.34, p<0.001). CONCLUSION: The incidence of osteoporotic re-fracture in this nationwide study was 15.5%, and the mortality rate of re-fracture patients was 1.2 times higher than that of non-refracture patients over a median follow up of 3 years.
Comorbidity
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Follow-Up Studies
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Humans
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Incidence
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Korea
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Mortality
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Osteoporotic Fractures
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Sample Size