Readmission of Stroke Patients and Risk Factors: Literature Review

  • Anna Jumatul Laely Faculty of Nursing, Universitas Airlangga & dr kariadi General Hospital
  • Nursalam Nursalam Faculty of Nursing, Universitas Airlangga
  • Ferry Efendi Faculty of Nursing, Universitas Airlangga
Keywords: risk factors, readmission, stroke


Stroke is still a concern for the health consent due to its high mortality and morbidity rates. Readmission of stroke patients is one of the factors that causes it. Risk factors that causing readmission of stroke patients are the main focus for nurses in order to give nursing services to patients in hospital. The aim of the research is to describe the evidence base for factors that cause readmission in stroke patients. This study is a literature review,with approach using 10 journals. Articles that were reviewed were selected from Google Scholar, Ebsco, Clinical key and Proquest which had been peer-reviewed and published. The inclusion criteria in the search were full-text articles, original text, English language, and the last 5 years, while the keywords used in the search for articles were caused factor, readmission, and stroke patient. The results of the data search obtained 539 articles, 10 articles were then reviewed. The articles used cross-sectional design (n=5) and cohort study (n=5), the cohort design consists of 3 retrospective studies, 2 prospective cohort studies. The causal factors related to the incidence of readmission in stroke patients are unpreventable factor and preventable factor of readmission. Unpreventable factors related to basic demographic data (age, gender, ethnicity, residences) and type of stroke. Meanwhile, preventable factors related to infection, complication of  comorbid and the patient's functional ability during discharge. Readmissions of stroke patients are an indicator of services quality  provided to patients during their hospitalization. Provision of services according to standards, prevention of infection and complications from patient are the main things that can reduce patient readmission rates.


Abreu, P., Magalhães, R., Baptista, D., Azevedo, E., Silva, M. C., & Correia, M. (2020). Readmissions and Mortality During the First Year After Stroke—Data From a Population-Based Incidence Study. Frontiers in Neurology, 11(July), 1–11.

Ang, S. H., Hwong, W. Y., Bots, M. L., Sivasampu, S., Aziz, A. F. A., Hoo, F. K., & Vaartjes, I. (2021). Risk of 28-day readmissions among stroke patients in Malaysia (2008–2015): Trends, causes and its associated factors. In PLoS ONE (Vol. 16, Issue 1 January). Public Library of Science.

Bjerkreim, A. T., Khanevski, A. N., Glad, S. B., Thomassen, L., Naess, H., & Logallo, N. (2018). Thirty-day readmission after spontaneous intracerebral hemorrhage. Brain and Behavior, 8(3).

Bjerkreim, A. T., Khanevski, A. N., Selvik, H. A., Waje-Andreassen, U., Thomassen, L., Naess, H., & Logallo, N. (2018). The Impact of Ischaemic Stroke Subtype on 30-day Hospital Readmissions. Stroke Research and Treatment, 2018.

Boehme, A. K., Kulick, E. R., Canning, M., Alvord, T., Khaksari, B., Omran, S., Willey, J. Z., & Elkind, M. S. V. (2018). Infections increase the risk of 30-day readmissions among stroke survivors: Analysis of the National Readmission Database. Stroke, 49(12), 2999–3005.

Chuang, K.-Y., Wu, S.-C., Ai-Hsuan, ·, Ma, S., Chen, Y.-H., & Wu, C.-L. (2005). Identifying Factors Associated With Hospital Readmissions Among Stroke Patients in Taipei. Journal of Nursing Research, 13(2), 117–127.

Jackson, A. H., Fireman, E., Feigenbaum, P., Neuwirth, E., Kipnis, P., & Bellows, J. (2014). Manual and automated methods for identifying potentially preventable readmissions: A comparison in a large healthcare system. BMC Medical Informatics and Decision Making, 14(1), 0–4.

Johnson, W., Onuma, O., Owolabi, M., & Sachdev, S. (2016). Stroke: A global response is needed. Bulletin of the World Health Organization, 94(9), 634A-635A.

Kemenkes RI. (2018). Stroke Dont Be The One (p. 10).

Khanevski, A. N., Bjerkreim, A. T., Novotny, V., Næss, H., Thomassen, L., Logallo, N., & Kvistad, C. E. (2018). Thirty-day recurrence after ischemic stroke or TIA. Brain and Behavior, 8(10).

Kilkenny, M. F., Dalli, L. L., Hons, B., Kim, J., Sundararajan, V., Andrew, N. E., Dewey, H. M., Johnston, T., Alif, S. M., Lindley, R. I., Jude, M., Blacker, D., Gange, N., Grimley, R., Katzenellenbogen, J. M., Thrift, A. G., Lannin, N. A., & Cadilhac, D. A. (2020). Factors Associated With 90-Day Readmission After Stroke or Transient Ischemic Attack Linked Data From the Australian Stroke Clinical Registry. 27–31.

Kitzman, P., Hudson, K., Sylvia, V., Feltner, F., & Lovins, J. (2017). Care Coordination for Community Transitions for Individuals Post-stroke Returning to Low-Resource Rural Communities. Journal of Community Health, 42(3), 565–572.

Kurniya, D., Elasari, Y., & Noor Anisa, F. (2020). Faktor-Faktor yang Mempengaruhi Terjadinya Readmissionpada Pasien Stroke di Rumah Sakit: Literature Review. Proceeding of Sari Mulia University Nursing National Seminars, 69–79.

Lin, S., Wang, C., Wang, Q., Xie, S., Tu, Q., Zhang, H., Peng, M., Zhou, J., & Redfern, J. (2022). The experience of stroke survivors and caregivers during hospital-to-home transitional care: A qualitative longitudinal study. International Journal of Nursing Studies, 130.

Miller, E. C., Wen, T., Elkind, M. S. V., Friedman, A. M., & Boehme, A. K. (2019). Infection During Delivery Hospitalization and Risk of Readmission for Postpartum Stroke. Stroke, 50(10), 2685–2691.

Swanson, J. O., & Moger, T. A. (2019). Comparisons of readmissions and mortality based on post-discharge ambulatory follow-up services received by stroke patients discharged home: A register-based study 11 Medical and Health Sciences 1117 Public Health and Health Services. BMC Health Services Research, 19(1).

Vahidy, F., Donnelly, J., McCullough, L., Tyson, J., Miller, C., Boehme, A., Savitz, S., & Albright, K. (2017). Nationwide Estimates of 30-Day Readmission in Patients With Ischemic Stroke. Stroke.

Visvanathan, V. (2019). Early supported discharge services for people with acute stroke: A Cochrane review summary. International Journal of Nursing Studies, 94, 186–187.

Wen, T., Liu, B., Wan, X., Zhang, X., Zhang, J., Zhou, X., Lau, A. Y. L., & Zhang, Y. (2018a). Risk factors associated with 31-day unplanned readmission in 50,912 discharged patients after stroke in China. BMC Neurology, 18(1).

Zhang, J., Zhu, P., Liu, B., Yao, Q., Yan, K., Zheng, Q., Li, Y., Zhang, L., Li, M., Wang, J., Zhu, C., & Zhou, M. (2019a). Time to recurrence after first-ever ischaemic stroke within 3 years and its risk factors in Chinese population: A prospective cohort study. BMJ Open, 9(12).

How to Cite
Laely, A. J., Nursalam, N., & Efendi, F. (2024). Readmission of Stroke Patients and Risk Factors: Literature Review. Indonesian Journal of Global Health Research, 6(1), 75-82.