Discharge Against Medical Advice in Acute Ischemic Stroke: the Risk of 30-Day Unplanned Readmission
Background Discharge against medical advice may be associated with more readmissions. Objective To evaluate DAMA in patients with acute ischemic stroke (AIS) and identify the relationship between DAMA and 30-day unplanned readmissions. Design A retrospective cohort study. Participants The National R...
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| Veröffentlicht in: | Journal of general internal medicine : JGIM 2021-05, Vol.36 (5), p.1206-1213 |
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| creator | Lin, Zhen Han, Hedong Wu, Cheng Wei, Xin Ruan, Yiming Zhang, Chenxu Cao, Yang He, Jia |
| description | Background
Discharge against medical advice may be associated with more readmissions.
Objective
To evaluate DAMA in patients with acute ischemic stroke (AIS) and identify the relationship between DAMA and 30-day unplanned readmissions.
Design
A retrospective cohort study.
Participants
The National Readmission Database was used to identify inpatients with a primary diagnosis of AIS who were either discharged home or DAMA between 2010 and 2017 in the USA.
Measures
Demographic features, hospital type, comorbidities, stroke risk factors, severity indices, and treatments were compared between patients discharged routinely and DAMA. Multivariable logistic regression was used to evaluate predictors of DAMA, and a double robust inverse probability of treatment weighting method was used to assess the association between DAMA and 30-day unplanned readmissions.
Key Results
Overall, 1,335,484 patients with AIS were included, of whom 2.09% (
n
= 27,892) were DAMA. The prevalence of DAMA in AIS patients increased from 1.65 in 2010 to 2.57% in 2017. The rates of 30-day unplanned readmissions for DAMA and non-DAMA patients were 16.81% and 7.78%, respectively. Patients with drug abuse, alcohol abuse, smoking, prior stroke, psychoses, and intravenous thrombolysis had greater odds of DAMA. DAMA was associated with all-cause readmissions (OR, 2.04; 95% CI, 2.01–2.07) and remained a strong predictor for transient ischemic attack/stroke-specific and cardiac-specific causes of readmissions.
Conclusions
Although the DAMA rate is low in AIS patients, DAMA is a risk factor for all-cause and recurrent stroke-specific readmissions. Future studies are needed to address issues around compliance and engagement with health care to reduce DAMA. |
| doi_str_mv | 10.1007/s11606-020-06366-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_708246</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2487749437</sourcerecordid><originalsourceid>FETCH-LOGICAL-c599t-ff3cddc7017c2b2c7a477bcd246ed090f0169532f95b535d2bda2715121b8f303</originalsourceid><addsrcrecordid>eNp9kk9vFCEAxYnR2LX6BTwYEi8eHOU_jAeTSbdqkxqTar0SBphdurPDCjM1_fZl3W1rTeqBQOD3HvDyAHiJ0TuMkHyfMRZIVIigCgkqyuoRmGFOeIVZLR-DGVKKVUpSdgCe5XyBEKaEqKfggFLOayTQDNh5yHZp0sLDZmHCkEf41btgTQ8bdxmsh2GAjZ1GD08K6NfBwu9jiiv_AY5LD89CXsHYQYqqubmC58OmN8PgHTzzxq1DziEOz8GTzvTZv9jPh-D80_GPoy_V6bfPJ0fNaWV5XY9V11HrnJUIS0taYqVhUrbWESa8QzXqEBY1p6Srecspd6R1hkjMMcGt6iiih6Da-ebffjO1epPC2qQrHU3Q-61VWXktkSqmha8f5DcpujvRjRCz8lIhJCnatw9q5-Fno2NalDFpVTOFC_5xhxd27Z31w5hMf__GeydDWOpFvNRFixndGrzZG6T4a_J51CVc6_uSto9T1oQpKVnNqCzo63_QiziloSSvCSdKUEXV9vNkR9kUc06-u30MRnpbL72rly710n_qpbcJv_r7G7eSmz4VgO5jKUfDwqe7u_9jew3Iy9v8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2528638386</pqid></control><display><type>article</type><title>Discharge Against Medical Advice in Acute Ischemic Stroke: the Risk of 30-Day Unplanned Readmission</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>SWEPUB Freely available online</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Lin, Zhen ; Han, Hedong ; Wu, Cheng ; Wei, Xin ; Ruan, Yiming ; Zhang, Chenxu ; Cao, Yang ; He, Jia</creator><creatorcontrib>Lin, Zhen ; Han, Hedong ; Wu, Cheng ; Wei, Xin ; Ruan, Yiming ; Zhang, Chenxu ; Cao, Yang ; He, Jia</creatorcontrib><description>Background
Discharge against medical advice may be associated with more readmissions.
Objective
To evaluate DAMA in patients with acute ischemic stroke (AIS) and identify the relationship between DAMA and 30-day unplanned readmissions.
Design
A retrospective cohort study.
Participants
The National Readmission Database was used to identify inpatients with a primary diagnosis of AIS who were either discharged home or DAMA between 2010 and 2017 in the USA.
Measures
Demographic features, hospital type, comorbidities, stroke risk factors, severity indices, and treatments were compared between patients discharged routinely and DAMA. Multivariable logistic regression was used to evaluate predictors of DAMA, and a double robust inverse probability of treatment weighting method was used to assess the association between DAMA and 30-day unplanned readmissions.
Key Results
Overall, 1,335,484 patients with AIS were included, of whom 2.09% (
n
= 27,892) were DAMA. The prevalence of DAMA in AIS patients increased from 1.65 in 2010 to 2.57% in 2017. The rates of 30-day unplanned readmissions for DAMA and non-DAMA patients were 16.81% and 7.78%, respectively. Patients with drug abuse, alcohol abuse, smoking, prior stroke, psychoses, and intravenous thrombolysis had greater odds of DAMA. DAMA was associated with all-cause readmissions (OR, 2.04; 95% CI, 2.01–2.07) and remained a strong predictor for transient ischemic attack/stroke-specific and cardiac-specific causes of readmissions.
Conclusions
Although the DAMA rate is low in AIS patients, DAMA is a risk factor for all-cause and recurrent stroke-specific readmissions. Future studies are needed to address issues around compliance and engagement with health care to reduce DAMA.</description><identifier>ISSN: 0884-8734</identifier><identifier>ISSN: 1525-1497</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-020-06366-0</identifier><identifier>PMID: 33559060</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acute ischemic stroke ; Alcohol abuse ; Brain Ischemia - diagnosis ; Brain Ischemia - epidemiology ; Brain Ischemia - therapy ; discharge against medical advice ; Drug abuse ; Evaluation ; Health risks ; Humans ; Internal Medicine ; Intravenous administration ; Ischemia ; Ischemic Stroke ; Medicin och hälsovetenskap ; Medicine ; Medicine & Public Health ; Original Research ; Patient Discharge ; Patient Readmission ; Patients ; Psychosis ; readmission ; Retrospective Studies ; Risk analysis ; risk factor ; Risk Factors ; Statistical analysis ; Stroke ; Stroke - diagnosis ; Stroke - epidemiology ; Stroke - therapy ; Thrombolysis ; Transient ischemic attack ; Weighting methods</subject><ispartof>Journal of general internal medicine : JGIM, 2021-05, Vol.36 (5), p.1206-1213</ispartof><rights>Society of General Internal Medicine 2021</rights><rights>Society of General Internal Medicine 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c599t-ff3cddc7017c2b2c7a477bcd246ed090f0169532f95b535d2bda2715121b8f303</citedby><cites>FETCH-LOGICAL-c599t-ff3cddc7017c2b2c7a477bcd246ed090f0169532f95b535d2bda2715121b8f303</cites><orcidid>0000-0002-2338-9501</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131431/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131431/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,552,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33559060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-89481$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:145996672$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Zhen</creatorcontrib><creatorcontrib>Han, Hedong</creatorcontrib><creatorcontrib>Wu, Cheng</creatorcontrib><creatorcontrib>Wei, Xin</creatorcontrib><creatorcontrib>Ruan, Yiming</creatorcontrib><creatorcontrib>Zhang, Chenxu</creatorcontrib><creatorcontrib>Cao, Yang</creatorcontrib><creatorcontrib>He, Jia</creatorcontrib><title>Discharge Against Medical Advice in Acute Ischemic Stroke: the Risk of 30-Day Unplanned Readmission</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>Background
Discharge against medical advice may be associated with more readmissions.
Objective
To evaluate DAMA in patients with acute ischemic stroke (AIS) and identify the relationship between DAMA and 30-day unplanned readmissions.
Design
A retrospective cohort study.
Participants
The National Readmission Database was used to identify inpatients with a primary diagnosis of AIS who were either discharged home or DAMA between 2010 and 2017 in the USA.
Measures
Demographic features, hospital type, comorbidities, stroke risk factors, severity indices, and treatments were compared between patients discharged routinely and DAMA. Multivariable logistic regression was used to evaluate predictors of DAMA, and a double robust inverse probability of treatment weighting method was used to assess the association between DAMA and 30-day unplanned readmissions.
Key Results
Overall, 1,335,484 patients with AIS were included, of whom 2.09% (
n
= 27,892) were DAMA. The prevalence of DAMA in AIS patients increased from 1.65 in 2010 to 2.57% in 2017. The rates of 30-day unplanned readmissions for DAMA and non-DAMA patients were 16.81% and 7.78%, respectively. Patients with drug abuse, alcohol abuse, smoking, prior stroke, psychoses, and intravenous thrombolysis had greater odds of DAMA. DAMA was associated with all-cause readmissions (OR, 2.04; 95% CI, 2.01–2.07) and remained a strong predictor for transient ischemic attack/stroke-specific and cardiac-specific causes of readmissions.
Conclusions
Although the DAMA rate is low in AIS patients, DAMA is a risk factor for all-cause and recurrent stroke-specific readmissions. Future studies are needed to address issues around compliance and engagement with health care to reduce DAMA.</description><subject>Acute ischemic stroke</subject><subject>Alcohol abuse</subject><subject>Brain Ischemia - diagnosis</subject><subject>Brain Ischemia - epidemiology</subject><subject>Brain Ischemia - therapy</subject><subject>discharge against medical advice</subject><subject>Drug abuse</subject><subject>Evaluation</subject><subject>Health risks</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Intravenous administration</subject><subject>Ischemia</subject><subject>Ischemic Stroke</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Research</subject><subject>Patient Discharge</subject><subject>Patient Readmission</subject><subject>Patients</subject><subject>Psychosis</subject><subject>readmission</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>risk factor</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Stroke - therapy</subject><subject>Thrombolysis</subject><subject>Transient ischemic attack</subject><subject>Weighting methods</subject><issn>0884-8734</issn><issn>1525-1497</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>D8T</sourceid><recordid>eNp9kk9vFCEAxYnR2LX6BTwYEi8eHOU_jAeTSbdqkxqTar0SBphdurPDCjM1_fZl3W1rTeqBQOD3HvDyAHiJ0TuMkHyfMRZIVIigCgkqyuoRmGFOeIVZLR-DGVKKVUpSdgCe5XyBEKaEqKfggFLOayTQDNh5yHZp0sLDZmHCkEf41btgTQ8bdxmsh2GAjZ1GD08K6NfBwu9jiiv_AY5LD89CXsHYQYqqubmC58OmN8PgHTzzxq1DziEOz8GTzvTZv9jPh-D80_GPoy_V6bfPJ0fNaWV5XY9V11HrnJUIS0taYqVhUrbWESa8QzXqEBY1p6Srecspd6R1hkjMMcGt6iiih6Da-ebffjO1epPC2qQrHU3Q-61VWXktkSqmha8f5DcpujvRjRCz8lIhJCnatw9q5-Fno2NalDFpVTOFC_5xhxd27Z31w5hMf__GeydDWOpFvNRFixndGrzZG6T4a_J51CVc6_uSto9T1oQpKVnNqCzo63_QiziloSSvCSdKUEXV9vNkR9kUc06-u30MRnpbL72rly710n_qpbcJv_r7G7eSmz4VgO5jKUfDwqe7u_9jew3Iy9v8</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Lin, Zhen</creator><creator>Han, Hedong</creator><creator>Wu, Cheng</creator><creator>Wei, Xin</creator><creator>Ruan, Yiming</creator><creator>Zhang, Chenxu</creator><creator>Cao, Yang</creator><creator>He, Jia</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D91</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-2338-9501</orcidid></search><sort><creationdate>20210501</creationdate><title>Discharge Against Medical Advice in Acute Ischemic Stroke: the Risk of 30-Day Unplanned Readmission</title><author>Lin, Zhen ; Han, Hedong ; Wu, Cheng ; Wei, Xin ; Ruan, Yiming ; Zhang, Chenxu ; Cao, Yang ; He, Jia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c599t-ff3cddc7017c2b2c7a477bcd246ed090f0169532f95b535d2bda2715121b8f303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute ischemic stroke</topic><topic>Alcohol abuse</topic><topic>Brain Ischemia - diagnosis</topic><topic>Brain Ischemia - epidemiology</topic><topic>Brain Ischemia - therapy</topic><topic>discharge against medical advice</topic><topic>Drug abuse</topic><topic>Evaluation</topic><topic>Health risks</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Intravenous administration</topic><topic>Ischemia</topic><topic>Ischemic Stroke</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Research</topic><topic>Patient Discharge</topic><topic>Patient Readmission</topic><topic>Patients</topic><topic>Psychosis</topic><topic>readmission</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>risk factor</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>Stroke - therapy</topic><topic>Thrombolysis</topic><topic>Transient ischemic attack</topic><topic>Weighting methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Zhen</creatorcontrib><creatorcontrib>Han, Hedong</creatorcontrib><creatorcontrib>Wu, Cheng</creatorcontrib><creatorcontrib>Wei, Xin</creatorcontrib><creatorcontrib>Ruan, Yiming</creatorcontrib><creatorcontrib>Zhang, Chenxu</creatorcontrib><creatorcontrib>Cao, Yang</creatorcontrib><creatorcontrib>He, Jia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Örebro universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Zhen</au><au>Han, Hedong</au><au>Wu, Cheng</au><au>Wei, Xin</au><au>Ruan, Yiming</au><au>Zhang, Chenxu</au><au>Cao, Yang</au><au>He, Jia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Discharge Against Medical Advice in Acute Ischemic Stroke: the Risk of 30-Day Unplanned Readmission</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><stitle>J GEN INTERN MED</stitle><addtitle>J Gen Intern Med</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>36</volume><issue>5</issue><spage>1206</spage><epage>1213</epage><pages>1206-1213</pages><issn>0884-8734</issn><issn>1525-1497</issn><eissn>1525-1497</eissn><abstract>Background
Discharge against medical advice may be associated with more readmissions.
Objective
To evaluate DAMA in patients with acute ischemic stroke (AIS) and identify the relationship between DAMA and 30-day unplanned readmissions.
Design
A retrospective cohort study.
Participants
The National Readmission Database was used to identify inpatients with a primary diagnosis of AIS who were either discharged home or DAMA between 2010 and 2017 in the USA.
Measures
Demographic features, hospital type, comorbidities, stroke risk factors, severity indices, and treatments were compared between patients discharged routinely and DAMA. Multivariable logistic regression was used to evaluate predictors of DAMA, and a double robust inverse probability of treatment weighting method was used to assess the association between DAMA and 30-day unplanned readmissions.
Key Results
Overall, 1,335,484 patients with AIS were included, of whom 2.09% (
n
= 27,892) were DAMA. The prevalence of DAMA in AIS patients increased from 1.65 in 2010 to 2.57% in 2017. The rates of 30-day unplanned readmissions for DAMA and non-DAMA patients were 16.81% and 7.78%, respectively. Patients with drug abuse, alcohol abuse, smoking, prior stroke, psychoses, and intravenous thrombolysis had greater odds of DAMA. DAMA was associated with all-cause readmissions (OR, 2.04; 95% CI, 2.01–2.07) and remained a strong predictor for transient ischemic attack/stroke-specific and cardiac-specific causes of readmissions.
Conclusions
Although the DAMA rate is low in AIS patients, DAMA is a risk factor for all-cause and recurrent stroke-specific readmissions. Future studies are needed to address issues around compliance and engagement with health care to reduce DAMA.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33559060</pmid><doi>10.1007/s11606-020-06366-0</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2338-9501</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of general internal medicine : JGIM, 2021-05, Vol.36 (5), p.1206-1213 |
| issn | 0884-8734 1525-1497 1525-1497 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals; SWEPUB Freely available online; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Acute ischemic stroke Alcohol abuse Brain Ischemia - diagnosis Brain Ischemia - epidemiology Brain Ischemia - therapy discharge against medical advice Drug abuse Evaluation Health risks Humans Internal Medicine Intravenous administration Ischemia Ischemic Stroke Medicin och hälsovetenskap Medicine Medicine & Public Health Original Research Patient Discharge Patient Readmission Patients Psychosis readmission Retrospective Studies Risk analysis risk factor Risk Factors Statistical analysis Stroke Stroke - diagnosis Stroke - epidemiology Stroke - therapy Thrombolysis Transient ischemic attack Weighting methods |
| title | Discharge Against Medical Advice in Acute Ischemic Stroke: the Risk of 30-Day Unplanned Readmission |
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