Objectives Length of hospital stay (LOS) is
a major cost component of hospital budgets. Accurate prediction of LOS has
become increasingly important for health care systems, and reducing the LOS has
the potential for large savings in the public hospital system. This study aimed
to assess the factors associated with prolonged LOS of acute ischemic stroke
taking into consideration demographic, risk factors, and clinical signs that
can be assessed at the time of admission. Particular attention is paid on the
impact of previous medication use on LOS.
Methods A
retrospective cohort study of all acute ischemic stroke survivors attending a
hospital in Malaysia from May 1, 2008 to December 31, 2008. Long hospital stay
was defined as a stay greater than or equal to the median of LOS. Data included
demographic information, clinical information, risk factors, and previous
medication use. SPSS version 15 was used for data analysis.
Results Overall,
363 patients were studied. The median (interquartile range) of LOS was 69
(45-111) hours. The independent factors associated with prolonged LOS were a
history of atrial fibrillation (P = 0.011), patients with moderate and
severe Glasgow Coma Scale (P = 0.001), patients with higher body
temperature (P = 0.015), patients with higher fasting or random blood
glucose (P = 0.004), and patients without previous use of angiotensin
converting enzyme inhibitor medication (P = 0.027).
Conclusions
This
study provided scientific data for the factors that could hamper the discharge,
particularly before clinicians can evaluate the most effective, efficient, and
acceptable methods of managing patients with acute ischemic stroke. Moreover,
these variables are potentially preventable or treatable at admission time and
would be ideal targets to reduce the burden of illness and healthcare costs of
ischemic stroke.
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