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Mohammad Rajabpour, Abbas Heidary , Kavian Ghandehari , Amir Mirhaghi,
Volume 81, Issue 10 (January 2024)
Abstract

Background: Despite advances in medical treatments, readmission of stroke patients remains high and has been reported between 31% and 56.1% during the first year after discharge. The difference between the risk factors of readmission and the risk factors of stroke is not clear. The purpose of this study is: 1) to determine the preventable risk factors associated with stroke readmission and 2) to provide a conceptual model for preventable factors that effective in the readmission of stroke patients.
Methods: This integrated review was performed according to Whittemore and Knafl (2005) method in five stages including problem identification, literature search, data evaluation, data analysis, and presentation. In order to find relevant articles, PubMed, Web of Science, CINAHL, Scopus databases and Google Scholar search engine were searched. The search was conducted using the keywords "stroke," "readmission," "recurrence," "re-hospitalization," "review," and "systematic review," for the period between January 2023 and September 2023, following the PRISMA guidelines. In addition to providing a qualitative synthesis of readmission factors categorized into categories, a conceptual model of these factors was also presented.
Results: Out of a total of 3785 article titles, 38 articles were included in the study for the final analysis after screening and removing duplicates. The most important risk factors for readmission in four categories: (1) knowledge deficit about the comorbidities (such as hypertension, atrial fibrillation, diabetes), (2) unhealthy diet and medicine, (3) high-risk behaviors (smoking, alcohol consumption, and tobacco use disorder), and (4) psychological distress (depression and worry about the future). In addition, the conceptual model showed that the most important preventable factor in readmission of stroke patients is of knowledge deficit about comorbidities (especially hypertension). 
Conclusion: The most important preventable risk factors that are effective in the readmission of stroke patients are knowledge deficit regarding clinical risk factors, especially high blood pressure, high-risk behaviors and unhealthy diet and medicine. Therefore, more detailed care and follow-up programs should be designed for stroke patients after discharge.


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