High levels of engagement reduced readmissions, improved outcomes in hemorrhagic stroke

High levels of patient engagement with nurse navigators after hospitalization for hemorrhagic stroke led to less disability and lower readmission rates after 90 days, according to research presented at International Stroke Conference.

Researchers at Allegheny Health Network in Pittsburgh aimed to evaluate whether engagement with nurse navigators affected readmissions and outcomes in patients with hemorrhagic stroke.

They conducted a retrospective study of patients from seven hospitals from January 2021 to April 2022 and enrolled 368 individuals, of whom 281 were included in analysis (217 with intracerebral hemorrhage and 64 with subarachnoid hemorrhage).

Navigators contacted patients to discuss care and medications, confirm appointments and provide education via phone or virtual encounters. Engagement was defined as low (< 5 encounters) or high ( 5 encounters) over a 90-day period.

The primary outcome was readmission within 90 days, and secondary outcomes included attendance of neurology visit, new or worsening symptoms and 90-day modified Rankin Scale (mRS) score.

According to results, 144 patients were less engaged and 137 were highly engaged. Those who were highly engaged were less likely to be readmitted compared with less engaged patients (23% vs. 42%; adjusted OR = 0.49; 95% CI, 0.28-0.87).

Researchers also reported that highly engaged patients had reduced disability at 90 days compared with less engaged patients (median mRS = 2 vs. 3; aOR = 0.49; 95% CI, 0.3-0.81). However, no differences were reported in engagement and appointment attendance (aOR = 1.73; 95% CI, 0.96-3.11) or new neurologic events (aOR = 0.52; 95% CI, 0.25-1.08).

“Highly engaged patients discharged to a health care facility were also less likely to be readmitted and had less disability at 90 days compared to less engaged patients,” Nicole Dellostretto, LPN, stroke nurse navigator at Allegheny General Hospital, and colleagues wrote.