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Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage

BACKGROUND: Length of stay (LOS) is an important indicator of the optimization of health services and hospital financing efficiency in aneurysmal subarachnoid hemorrhage (aSAH) patients. The purpose of this study was to develop a scoring model to predict the LOS of patients with aSAH. METHOD: A clin...

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Detalles Bibliográficos
Autores principales: Prasetyo, Bambang Tri, Kurniawan, Ricky Gusanto, Rilianto, Beny, Windiani, Pratiwi Raissa, Gotama, Kelvin Theandro, Salam, Sardiana, Sari, Ita Muharram, Musridharta, Eka, Arham, Abrar, Kusdiansah, Muhammad, Kiemas, Lyna Soertidewi, Bustami, Mursyid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273541/
https://www.ncbi.nlm.nih.gov/pubmed/37328746
http://dx.doi.org/10.1186/s12883-023-03279-3
Descripción
Sumario:BACKGROUND: Length of stay (LOS) is an important indicator of the optimization of health services and hospital financing efficiency in aneurysmal subarachnoid hemorrhage (aSAH) patients. The purpose of this study was to develop a scoring model to predict the LOS of patients with aSAH. METHOD: A clinical scoring was developed based on retrospectively collected data from the cerebral aneurysm registry of the National Brain Center Hospital, Jakarta, from January 2019 to June 2022. Multivariate logistic regression was used to determine the odds ratio for risk-adjusted prolonged LOS. LOS predictors were obtained based on the regression coefficients and converted into a point score model. RESULTS: Of the 209 aSAH patients observed, 117 patients had prolonged LOS (> 14 days of hospital stay). A clinical score was developed with a range of 0–7 points. Four variables were chosen as predictors of prolonged LOS: the presence of high-grade aSAH (1 point), aneurysm treatment (endovascular coiling: 1 point; surgical clipping: 2 points), cardiovascular comorbidities (1 point), and hospital-acquired pneumonia (3 points). The score showed good discrimination with an area under the receiving operating characteristics curve (AUC) of 0.8183 (SE 0.0278) and a p-value for the Hosmer–Lemeshow (HL) goodness-of-fit of 0.9322. CONCLUSION: This simple clinical score reliably predicted prolonged LOS in aneurysmal subarachnoid hemorrhage cases and may aid clinicians in improving patient outcomes and decreasing healthcare costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-023-03279-3.