Volume 4, Issue 4 (Autumn 2018)                   Caspian J Neurol Sci 2018, 4(4): 169-177 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Majidi Shad M, Saberi A, Shakiba M, Rezamasouleh S. Evaluating the Duration of Hospitalization and Its Related Factors Among Stroke Patients. Caspian J Neurol Sci 2018; 4 (4) :169-177
URL: http://cjns.gums.ac.ir/article-1-250-en.html
1- Student of Medicine, Student Research Committee of Neurosciences Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
2- Professor of Neurology, Neurosciences Research Center, Neurology Department, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran , alia.saberi1@gmail.com
3- Assistant Professor of Epidemiology, Road Trauma Research Center, School of Health, Guilan University of Medical Sciences, Rasht, Iran
4- Lecturer in Nursing, Department of Medical Surgical Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
Abstract:   (2242 Views)
Background: Prolong hospitalization after a stroke is associated with increased cost, higher risk of complications, and adverse effects. 
Objectives: The purpose of this study was to determine the length of stay and its related factors among stroke patients admitted to one of the educational and therapeutic centers in the north of Iran.
Materials & Methods: In this descriptive-analytic study, 253 stroke patients admitted to an academic hospital affiliated to Guilan University of Medical Sciences were enrolled during 2016-2017. Their socio-demographic characteristics and medical records associated with their admission were collected. A linear regression model was used to estimate the adjusted risk factors in predicting the duration of hospitalization in SPSS 21.
Results: The Mean±SD duration of hospitalization in stroke patients was 5.6±2.1 days (range 2-12 days). The multivariate regression model indicated that the unemployed versus the self-employed subjects (β=0.74), hemorrhagic versus the ischemic stroke (β=0.84), strokes with moderate volume (β=0.61) and large volume (β=1.22) compared to small volume, infectious complications, and certain physicians had an independent and significant association with increased duration of hospital stay.
Conclusion: Assessing the duration of hospitalization and identifying its potential predictors can be useful in the proper use of the resources and discharge of patients with stroke.
Keywords: Length of stay, Stroke
Full-Text [PDF 1327 kb]   (769 Downloads) |   |   Full-Text (HTML)  (1243 Views)  
Type of Study: Research | Subject: Special
Received: 2018/03/13 | Accepted: 2018/08/23 | Published: 2018/10/1

References
1. d Health Organization. STEPS-Stroke manual (version 1.2): The WHO STEPwise approach to stroke surveillance. Geneva: World Health Organization; 2013.
2. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2016 update: A report from the American Heart Association. Circulation. 2016; 133(4):e38-e360. h [DOI:10.1161/CIR.0000000000000366] [PMID] [DOI:10.1161/CIR.0000000000000366]
3. Saxena A, Prasad R, Verma K, Saxena S. Factors predicting length of hospital stay in acute stroke patients admitted in a rural tertiary care hospital. J Gerontol Geriatr Res S. 2016; 5:2. [DOI:10.4172/2167-7182.S5-003] [DOI:10.4172/2167-7182.S5-003]
4. Morris S, Hunter RM, Ramsay AI, Boaden R, McKevitt C, Perry C, et al. Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: Difference-in-differences analysis. BMJ. 2014; 349:g4757. [DOI:10.1136/bmj.g4757] [PMID] [PMCID] [DOI:10.1136/bmj.g4757]
5. Kim SM, Hwang SW, Oh EH, Kang JK. Determinants of the length of stay in stroke patients. Osong Public Health Res Perspect. 2013; 4(6):329-41. [DOI:10.1016/j.phrp.2013.10.008] [PMID] [PMCID] [DOI:10.1016/j.phrp.2013.10.008]
6. Kwok C, Clark A, Musgrave S, Potter J, Dalton G, Day D, et al. The SOAR stroke score predicts hospital length of stay in acute stroke: an external validation study. Int J Clin Pract Suppl. 2015; 69(6):659-65. [DOI:10.1111/ijcp.12577] [PMID] [DOI:10.1111/ijcp.12577]
7. Spratt N, Wang Y, Levi C, Ng K, Evans M, Fisher J. A prospective study of predictors of prolonged hospital stay and disability after stroke. J Clin Neurosci. 2003; 10(6):665-9. [DOI:10.1016/j.jocn.2002.12.001] [PMID] [DOI:10.1016/j.jocn.2002.12.001]
8. Somerford PJ, Lee AH, Yau KK. Ischemic stroke hospital stay and discharge destination. Ann Epidemiol. 2004; 14(10):773-7. [DOI:10.1016/j.annepidem.2004.02.003] [PMID] [DOI:10.1016/j.annepidem.2004.02.003]
9. Seet RC, Lim EC, Chan Y, Chan BP, Quek AM, Ong BK. Can demographic and admission laboratory variables be useful to identify long-stay patients with acute ischemic stroke? A hospital-based cohort study in Singapore. Neurol Sci. 2009; 30(4):275-80. [DOI:10.1007/s10072-009-0084-0] [PMID] [DOI:10.1007/s10072-009-0084-0]
10. Lim JH, Cheon SH. Analysis of variation in length of stay (LOS) after ischemic and hemorrhagic stroke using the Charlson Comorbidity Index (CCI). J Phys Ther Sci. 2015; 27(3):799-803. [DOI:10.1589/jpts.27.799] [PMID] [PMCID] [DOI:10.1589/jpts.27.799]
11. Martin S, Smith P. Explaining variations in inpatient length of stay in the National Health Service.J Health Econ. 1996; 15(3):279-304. [DOI:10.1016/0167-6296(96)00003-3] [DOI:10.1016/0167-6296(96)00003-3]
12. McMullan R, Silke B, Bennett K, Callachand S. Resource utilisation, length of hospital stay, and pattern of investigation during acute medical hospital admission. Postgrad Med J. 2004; 80(939):23-6. [DOI:10.1136/pmj.2003.007500] [PMID] [PMCID] [DOI:10.1136/pmj.2003.007500]
13. Clarke A. Length of in-hospital stay and its relationship to quality of care. BMJ Qual Saf. 2002; 11(3):209-10. [DOI:10.1136/qhc.11.3.209] [PMCID] [DOI:10.1136/qhc.11.3.209]
14. Hashemi-Fard A, Saffari S, Adnan R. [Analysis of hospitalization length for cerebrovascular accident patients in Sabzevar Vaseyee hospital using count regression models (Persian)]. Daneshvar Med. 2014; 21(109):17-24.
15. Kang JH, Bae HJ, Choi YA, Lee SH, Shin HI. Length of hospital stay after stroke: A Korean nationwide study. Ann Rehabil Med. 2016; 40(4):675-81. [DOI:10.5535/arm.2016.40.4.675] [PMID] [PMCID]
16. Göz E, Kahraman T, Genc A, Kaya Ö, Öztürk V, Kutluk K. [Factors affecting hospital length of stay among patients with acute stroke (Turkish)]. J Neurol Sci. 2017; 34(2):143-52.
17. Chang KC, Tseng MC. Costs of acute care of first-ever ischemic stroke in Taiwan. Stroke. 2003; 34(11):e219-e21. [DOI:10.1161/01.STR.0000095565.12945.18] [PMID] [DOI:10.1161/01.STR.0000095565.12945.18]
18. Svendsen ML, Ehlers LH, Andersen G, Johnsen SP. Quality of care and length of hospital stay among patients with stroke. Med Care. 2009; 47(5):575-82. [DOI:10.1097/MLR.0b013e318195f852] [PMID] [DOI:10.1097/MLR.0b013e318195f852]
19. Lee HC, Chang KC, Lan CF, Hong CT, Huang YC, Chang ML. Factors associated with prolonged hospital stay for acute stroke in Taiwan. Acta Neurol Taiwan. 2008; 17(1):17-25. [PMID] [PMID]
20. Adler R, MacRitchie K, Engel GL. Psychologic processes and ischemic stroke (occlusive cerebrovascular disease): I. observations on 32 men with 35 Strokes. Psychosom Med. 1971; 33(1):1-30. [DOI:10.1097/00006842-197101000-00001] [PMID] [DOI:10.1097/00006842-197101000-00001]
21. Meer J, Rosen HS. Insurance and the utilization of medical services. Soc Sci Med. 2004; 58(9):1623-32. [DOI:10.1016/S0277-9536(03)00394-0] [DOI:10.1016/S0277-9536(03)00394-0]
22. Liu Y, Phillips M, Codde J. Factors influencing patients' length of stay. Aust Health Rev. 2001; 24(2):63-70. [DOI:10.1071/AH010063] [PMID] [DOI:10.1071/AH010063]
23. Lang PO, Zekry D, Michel JP, Drame M, Novella JL, Jolly D, et al. Early markers of prolonged hospital stay in demented inpatients: A multicentre and prospective study. J Nutr Health Aging. 2010; 14(2):141-7. [DOI:10.1007/s12603-009-0182-y] [DOI:10.1007/s12603-009-0182-y]
24. Arab M, Zarei A, Rahimi A, Rezaiean F, Akbari F. [Analysis of factors affecting length of stay in public hospitals in Lorestan province, Iran (Persian)]. Hakim Res J. 2010; 12(4):27-32.
25. Akbari Sari A, Rezaei S, Arab M, Karami Matin B, Majdzadeh R. Does smoking status affect cost of hospitalization? Evidence from three main diseases associated with smoking in Iran. Med J Islam Repub Iran. 2017; 31(1):363-7. [DOI:10.14196/mjiri.31.63] [PMID] [PMCID] [DOI:10.14196/mjiri.31.63]
26. Hvidtfeldt UA, Rasmussen S, Gronbaek M, Becker U, Tolstrup JS. Influence of smoking and alcohol consumption on admissions and duration of hospitalization. Eur J Public Health. 2010; 20(4):376-82. [DOI:10.1093/eurpub/ckp153] [PMID] [DOI:10.1093/eurpub/ckp153]
27. Arboix A, Massons J, García-Eroles L, Targa C, Oliveres M, Comes E. Clinical predictors of prolonged hospital stay after acute stroke: Relevance of medical complications. Int J Clin Med. 2012; 3(6):Article:24547. [DOI:10.4236/ijcm.2012.36090] [DOI:10.4236/ijcm.2012.36090]
28. Li Y, Liu H, Wang J, Li Y, Yu GP, Ma XM, et al. Variable lengths of stay among ischemic stroke subtypes in Chinese general teaching hospitals. PLoS One. 2012; 7(9):e45101. [DOI:10.1371/journal.pone.0045101] [PMID] [PMCID] [DOI:10.1371/journal.pone.0045101]
29. George AJ, Boehme AK, Siegler JE, Monlezun D, Fowler BD, Shaban A, et al. Hospital-acquired infection underlies poor functional outcome in patients with prolonged length of stay. ISRN stroke. 2013; 2013.
30. Koton S, Bornstein N, Tsabari R, Tanne D, Investigators N. Derivation and validation of the prolonged length of stay score in acute stroke patients. Neurology. 2010; 74(19):1511-6. [DOI:10.1212/WNL.0b013e3181dd4dc5] [PMID] [DOI:10.1212/WNL.0b013e3181dd4dc5]
31. Kwok CS, Clark A, Ford GA, Durairaj R, Dixit AK, Davis J, et al. Association between prestroke disability and inpatient mortality and length of acute hospital stay after acute stroke. J Am Geriatr Soc. 2012; 60(4):726-32. [DOI:10.1111/j.1532-5415.2011.03889.x] [PMID] [DOI:10.1111/j.1532-5415.2011.03889.x]
32. Curtain JP, Yu M, Clark AB, Gollop ND, Bettencourt-Silva JH, Metcalf AK, et al. Determinants of length of stay following total anterior circulatory stroke. Geriatrics. 2017; 2(3):26. [DOI:10.3390/geriatrics2030026] [DOI:10.3390/geriatrics2030026]
33. Qureshi AI, Adil MM, Zacharatos H, Suri MFK. Factors associated with length of hospitalization in patients admitted with transient ischemic attack in United States. Stroke. 2013; 44(6):1601-5. [DOI:10.1161/STROKEAHA.111.000590] [PMID] [DOI:10.1161/STROKEAHA.111.000590]
34. Huang YC, Hu CJ, Lee TH, Yang JT, Weng HH, Lin LC, et al. The impact factors on the cost and length of stay among acute ischemic stroke. J Stroke Cerebrovasc Dis. 2013; 22(7):e152-e8. [DOI:10.1016/j.jstrokecerebrovasdis.2012.10.014] [PMID] [DOI:10.1016/j.jstrokecerebrovasdis.2012.10.014]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Caspian Journal of Neurological Sciences

Designed & Developed by : Yektaweb