Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Exploring key risk factors for loss to follow-up after hospitalization for acute stroke.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kummer Benjamin R, Hwang Soonmyung A, Agarwal Parul, Morozov Masha, Davy Connor M, Tosto-Mancuso Jenna, Dangayach Neha S
Аннотация
BACKGROUND: A significant proportion of stroke patients are lost to follow-up (LTFU) after discharge, which may increase risks of morbidity, mortality, and unnecessary hospitalization. We aimed to identify predictors of post-discharge LTFU in acute stroke patients from a large academic hospital system.
METHODS: Using the American Heart Association's Get With the Guidelines registry, we conducted a retrospective analysis of acute stroke patients hospitalized at the Mount Sinai Hospital from January 2016 to December 2020. Our primary outcome was post-discharge LTFU (i.e. no ambulatory encounters within 12 months post-discharge). We used the least-absolute square and shrinkage operator (LASSO) for variable selection, then used multiple logistic regression to model the association of selected predictors with our primary outcome.
RESULTS: We identified 2,597 patients, of whom 878 (33.8%) were LTFU. Patients LTFU were more likely to be male (52.9% vs. 47.4%, p = 0.0088), admitted for intracerebral hemorrhage (12.1% vs. 8.9%, p = 0.0047), discharged to skilled nursing facilities (19.8% vs. 17.0%, p < 0.001), and transferred from another hospital (48.0% vs. 40.7%, p = 0.0030). These patients were more likely to have a discharge modified Rankin Scale (mRS) score of 4-5 (35.2% vs. 30.2%, p = 0.0060) and had a higher mean discharge NIHSS score (6.1 vs. 4.9, p < 0.001). In the adjusted analysis, patients who self-paid (adjusted odds ratio (aOR) 3.8, 95%CI 1.3-11.4), were discharged to acute care facilities (aOR 5.3, 95%CI 1.5-18.4), or had a mRS of 5 (aOR 2.4, 95%CI 1.0-5.7) had significantly increased odds of LTFU. Patients with Medicare coverage (aOR 0.60, 95%CI 0.40-0.92), discharge to inpatient rehabilitation (aOR 0.54, 95%CI 0.34-0.86), family history of stroke (aOR 0.37, 95%CI 0.18-0.76) had significantly decreased odds of LTFU.
CONCLUSIONS: In this study, we identified clinical characteristics and discharge dispositions associated with LTFU after stroke.
METHODS: Using the American Heart Association's Get With the Guidelines registry, we conducted a retrospective analysis of acute stroke patients hospitalized at the Mount Sinai Hospital from January 2016 to December 2020. Our primary outcome was post-discharge LTFU (i.e. no ambulatory encounters within 12 months post-discharge). We used the least-absolute square and shrinkage operator (LASSO) for variable selection, then used multiple logistic regression to model the association of selected predictors with our primary outcome.
RESULTS: We identified 2,597 patients, of whom 878 (33.8%) were LTFU. Patients LTFU were more likely to be male (52.9% vs. 47.4%, p = 0.0088), admitted for intracerebral hemorrhage (12.1% vs. 8.9%, p = 0.0047), discharged to skilled nursing facilities (19.8% vs. 17.0%, p < 0.001), and transferred from another hospital (48.0% vs. 40.7%, p = 0.0030). These patients were more likely to have a discharge modified Rankin Scale (mRS) score of 4-5 (35.2% vs. 30.2%, p = 0.0060) and had a higher mean discharge NIHSS score (6.1 vs. 4.9, p < 0.001). In the adjusted analysis, patients who self-paid (adjusted odds ratio (aOR) 3.8, 95%CI 1.3-11.4), were discharged to acute care facilities (aOR 5.3, 95%CI 1.5-18.4), or had a mRS of 5 (aOR 2.4, 95%CI 1.0-5.7) had significantly increased odds of LTFU. Patients with Medicare coverage (aOR 0.60, 95%CI 0.40-0.92), discharge to inpatient rehabilitation (aOR 0.54, 95%CI 0.34-0.86), family history of stroke (aOR 0.37, 95%CI 0.18-0.76) had significantly decreased odds of LTFU.
CONCLUSIONS: In this study, we identified clinical characteristics and discharge dispositions associated with LTFU after stroke.