Systematic Reviews of Hospital Readmission Risk Screening: Reflective Case Study of Older Adults with Stroke

Abstract

Stroke remains a leading cause of death and disability, with older adults disproportionately affected. This study aimed to investigate stroke patients’ short-and long-term readmissions to develop a new readmission risk screening tool (RRST) by conducting a systematic review and examining reflective cases reported to validate screening applications. Methods: A comprehensive search was conducted on 4 databases; eligible systematic reviews via CINAHL, MEDLINE/PubMed, Ovid UML, and Cochrane Library, with 14 research articles emerging to be content extracted as the 1st draft. Expert opinion assessed findings, then revised them to develop a new RRST draft and checked it with a reflective quality check of 4 selected, screened cases. The review identified 14 studies using 5 screening tools. ISAR, TRST, and HOSPITAL score showed low to moderate validity and moderate to good reliability. The Risk Readmission Assessment Tool (RRAT) and LACE index validity and reliability scores were low to moderate. Hospital readmission predictors were hospital admission history, polypharmacy, cognitive and memory problems, the need for help, difficulties in walking, length of stay, and comorbid conditions. The 4 cases reported reflecting the developed RRST screening showed all common features. Value-added, the new RRST could accurately predict high-risk hospital readmission groups; the extended RRST tool screening quality is to be verified in clinical and community trials.