Impact of the COVID-19 Pandemic on 30-Day Readmission Rates in Hospitalized Stroke Patients: A Retrospective Cohort Study

COVID-19 大流行对住院卒中患者 30 天再入院率的影响:一项回顾性队列研究

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Abstract

BACKGROUND: Stroke is one of the leading causes of disability and mortality worldwide, and the 30-day readmission rate is a crucial indicator for assessing the quality of healthcare and patient outcomes. Previous studies have reported a readmission rate of approximately 10%-20%. OBJECTIVES: This study investigated the impact of the COVID-19 pandemic on the readmission rate at 30 days among hospitalized stroke patients. METHODS: This retrospective cohort study was conducted in a 1500-bed medical center in central Taiwan between January 1, 2020, and December 31, 2023. Data, including 5095 hospitalized stroke patients, 505 readmissions within 30 days, and multiple variables that influence hospital readmission at 30 days, including demographics, clinical characteristics, physiological data, and medication use before discharge, were obtained from hospital electronic health records (EHR). RESULTS: The results revealed a significant decline in 30-day readmission rates between the early (2020∼2021) and latter (2022∼2023) phases of the pandemic, decreasing from 10.71% to 8.97% (P = .039). This reduction may be attributed to improvements in medical strategies, increased adoption of telemedicine, and improved post-discharge care. Generalized linear regression analysis indicated that male patients were at higher risk of readmission than female patients (OR = 1.28, P = .01), while other variables, such as age, BMI, and blood pressure, did not reach statistical significance. Furthermore, common cardiovascular and metabolic medications (antithrombotic agents, lipid-lowering drugs, antihypertensive drugs, and antidiabetic medications) did not significantly affect the risk of readmission (P > .05). CONCLUSIONS: This finding suggests that improvements in medical management during the early pandemic phase may have contributed to a reduced risk of readmission. Furthermore, male patients had a higher risk of readmission, highlighting the need for improved care strategies for this group.

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