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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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Autores principales: Lin, Kuan-Hung, Lin, Huey-Juan, Yeh, Poh-Shiow
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225000/
https://www.ncbi.nlm.nih.gov/pubmed/35743530
http://dx.doi.org/10.3390/jcm11123457
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author Lin, Kuan-Hung
Lin, Huey-Juan
Yeh, Poh-Shiow
author_facet Lin, Kuan-Hung
Lin, Huey-Juan
Yeh, Poh-Shiow
author_sort Lin, Kuan-Hung
collection PubMed
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.
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spelling pubmed-92250002022-06-24 Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke Lin, Kuan-Hung Lin, Huey-Juan Yeh, Poh-Shiow J Clin Med Article 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. MDPI 2022-06-16 /pmc/articles/PMC9225000/ /pubmed/35743530 http://dx.doi.org/10.3390/jcm11123457 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lin, Kuan-Hung
Lin, Huey-Juan
Yeh, Poh-Shiow
Determinants of Prolonged Length of Hospital Stay in Patients with Severe Acute Ischemic Stroke
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225000/
https://www.ncbi.nlm.nih.gov/pubmed/35743530
http://dx.doi.org/10.3390/jcm11123457
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