Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke
Objective: Long hospitalizations are associated with a high comorbidity and considerable hospital cost. Admissions of severe acute ischemic stroke are prone to longer hospitalizations. We aimed to explore the issue and method for improving the length of stay. Methods: From the prospective Stroke Reg...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/12/3457 |
| _version_ | 1797485979794145280 |
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| author | Kuan-Hung Lin Huey-Juan Lin Poh-Shiow Yeh |
| author_facet | Kuan-Hung Lin Huey-Juan Lin Poh-Shiow Yeh |
| author_sort | Kuan-Hung Lin |
| collection | DOAJ |
| description | Objective: Long hospitalizations are associated with a high comorbidity and considerable hospital cost. Admissions of severe acute ischemic stroke are prone to longer hospitalizations. We aimed to explore the issue and method for improving the length of stay. Methods: From the prospective Stroke Registry between January 2019 and June 2020, acute ischemic strokes with an admission National Institutes of Health Stroke Scale ≥ 15 were identified. Prolonged length-of-stay was defined as in-hospital-stay ≥ 30 days. All clinical characteristics were collected, and all do-not-resuscitate documentations were categorized if the order had been written within 7 days of onset. Results: A total of 212 patients were eligible for severe stroke. Of these, 42 (19.8%) had prolonged length-of-stay and 170 had non-prolonged length-of-stay (median 43 vs. 13 days). The prolonged group was younger, mostly men, and was more likely to be in an independent state and more likely to receive reperfusion therapy, and there was a higher frequency of late do-not-resuscitate orders if signed. Although there was a lower in-hospital mortality rate in the prolonged group (12% vs. 23%), there was a higher proportion with a severe functional state (Modified Rankin Scale = 4–5) among the survivors (97% vs. 87%). Conclusions: Severe acute ischemic stroke patients with a prolonged length-of-stay were younger, mostly male, more likely to receive reperfusion therapy, less likely to have an early do-not-resuscitate order if signed, and more likely to have poor functional status at discharge, although there was a lower rate of in-hospital mortality. |
| first_indexed | 2024-03-09T23:27:34Z |
| format | Article |
| id | doaj.art-aeed77a1a9d5497e9e52f7a41973cfac |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:27:34Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-aeed77a1a9d5497e9e52f7a41973cfac2023-11-23T17:16:25ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011112345710.3390/jcm11123457Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic StrokeKuan-Hung Lin0Huey-Juan Lin1Poh-Shiow Yeh2Chi-Mei Medical Center, Department of Neurology, 901 Chung-Hwa Road, Yung-Kang District, Tainan 71004, TaiwanChi-Mei Medical Center, Department of Neurology, 901 Chung-Hwa Road, Yung-Kang District, Tainan 71004, TaiwanChi-Mei Medical Center, Department of Neurology, 901 Chung-Hwa Road, Yung-Kang District, Tainan 71004, TaiwanObjective: Long hospitalizations are associated with a high comorbidity and considerable hospital cost. Admissions of severe acute ischemic stroke are prone to longer hospitalizations. We aimed to explore the issue and method for improving the length of stay. Methods: From the prospective Stroke Registry between January 2019 and June 2020, acute ischemic strokes with an admission National Institutes of Health Stroke Scale ≥ 15 were identified. Prolonged length-of-stay was defined as in-hospital-stay ≥ 30 days. All clinical characteristics were collected, and all do-not-resuscitate documentations were categorized if the order had been written within 7 days of onset. Results: A total of 212 patients were eligible for severe stroke. Of these, 42 (19.8%) had prolonged length-of-stay and 170 had non-prolonged length-of-stay (median 43 vs. 13 days). The prolonged group was younger, mostly men, and was more likely to be in an independent state and more likely to receive reperfusion therapy, and there was a higher frequency of late do-not-resuscitate orders if signed. Although there was a lower in-hospital mortality rate in the prolonged group (12% vs. 23%), there was a higher proportion with a severe functional state (Modified Rankin Scale = 4–5) among the survivors (97% vs. 87%). Conclusions: Severe acute ischemic stroke patients with a prolonged length-of-stay were younger, mostly male, more likely to receive reperfusion therapy, less likely to have an early do-not-resuscitate order if signed, and more likely to have poor functional status at discharge, although there was a lower rate of in-hospital mortality.https://www.mdpi.com/2077-0383/11/12/3457prolonged length of staylength of hospital staysevere acute ischemic strokedo-not-resuscitatefunctional outcome |
| spellingShingle | Kuan-Hung Lin Huey-Juan Lin Poh-Shiow Yeh Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke Journal of Clinical Medicine prolonged length of stay length of hospital stay severe acute ischemic stroke do-not-resuscitate functional outcome |
| title | Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke |
| title_full | Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke |
| title_fullStr | Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke |
| title_full_unstemmed | Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke |
| title_short | Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke |
| title_sort | determinants of prolonged length of hospital stay in patients with severe acute ischemic stroke |
| topic | prolonged length of stay length of hospital stay severe acute ischemic stroke do-not-resuscitate functional outcome |
| url | https://www.mdpi.com/2077-0383/11/12/3457 |
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