Infection as a Key Determinant of Readmission in Stroke  Patients: A Systematic Review and Meta-Analysis

Abbas  Heydari; Amir   Mirhaghi; Kavian  Ghandehari; Mohammad   Rajabpour

doi:10.18502/ijph.v54i7.19145

Abbas Heydari Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Amir Mirhaghi Department of Medical Emergencies, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Kavian Ghandehari Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Rajabpour Department of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/ijph.v54i7.19145

Keywords: Risk factors; Readmission; Stroke; Cerebrovascular accident; Infection

Abstract

Background: Accurately identifying the relationship between infection and the readmission of stroke patients leads to emphasis more the corresponding strategies. We aimed to determine the relationship between infection and readmission in stroke patients.

Methods: This systematic review and meta-analysis was based on PRISMA 2020 guidelines. A comprehensive search was performed across multiple databases, including PubMed, Web of Science, CINAHL, Scopus, and Google Scholar, using keywords such as "stroke," "readmission," "recurrence," "re-hospitalization," and "infection" up to 2024. The rate of readmissions due to infection, along with the Odds Ratio (OR) for infection, was calculated using a random effects model via Comprehensive Meta-Analysis V.2 software.

Results: Based on the reviewed studies, the 30-day readmission rate of stroke patients due to infection ranged from 6.5% to 30.0% and the one-year readmission rate ranged from 5.1% to 24.5%. Also, infection is an important risk factor in the readmission of stroke patients based on cohort studies (RR 1.38, 95% CI: 1.16-1.65, P<0.001), case-control (OR 1.68, 95% CI: 1.16-2.42, P= 0.006) and descriptive-analytical (OR 1.31, 95% CI: 1.07-1.59, P= 0.008).

Conclusion: The readmission rate of stroke due to infection is high and tackling infection-related readmissions in stroke patients necessitates a holistic strategy that combines clinical care, technological advancements, and education. More studies are needed in this field.