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Published on: February 22, 2020
Predictors of prolonged hospital stay in a Comprehensive Stroke Unit
Ana Paula Gaspari1, Elaine Drehmer de Almeida Cruz2, Josemar Batista3
1Universidade Federal do Paraná, Complexo Hospitalar de Clínicas, Curitiba, PR, Brasil.
Insights
Pneumonia and urinary tract infections significantly prolonged hospital stays for ischemic stroke patients. Preventing these complications is key to reducing length of stay in stroke units.
Area of Science:
- Neurology
- Internal Medicine
- Public Health
Background:
- Prolonged hospital stays in stroke patients are associated with increased risks of in-hospital complications.
- Identifying predictors of extended hospitalization is crucial for optimizing stroke unit care and resource allocation.
Purpose of the Study:
- To analyze the in-hospital complications that contribute to prolonged hospital stays in patients with ischemic stroke or transient ischemic attack.
- To identify preventable complications that significantly impact length of stay in a tertiary hospital's stroke unit.
Main Methods:
- An evaluative correlational study retrospectively analyzed first-ever ischemic stroke or transient ischemic attack patients.
- Predictors of long-term hospitalization included clinical complications (pneumonia, UTI, pressure damage, DVT) and neurological complications (malignant stroke, hemorrhagic transformation).
Main Results:
- 353 patients were analyzed; mean age was 64.1 years, with 52.6% males.
- Pneumonia (25.3 days), urinary tract infection (32.9 days), and malignant stroke (29.1 days) significantly increased length of hospital stay compared to uncomplicated cases (11.2 days).
Conclusions:
- Pneumonia and urinary tract infection were identified as significant, preventable complications delaying discharge in stroke unit patients.
- Implementing enhanced preventive measures for pneumonia and UTIs is recommended to reduce length of stay in stroke units.
Objective:
to analyze the in-hospital complications of prolonged hospital stay in patients with ischemic stroke or transient ischemic attack, admitted to the stroke unit of a tertiary hospital.
Method:
this is an evaluative correlational study. All first-ever ischemic stroke or transient ischemic attack patients admitted were retrospectively analyzed. During hospital stay, the predictors of long-term hospitalization considered were: 1) clinical complications (pneumonia, urinary tract infection, pressure damage and deep vein thrombosis), and 2) neurological complications (malignant ischemic stroke and symptomatic hemorrhagic transformation).
Results:
353 patients were discharged in the study period. Mean age was 64.1±13.7 years old and 186 (52.6%) were men. The mean time of hospital stay was 13.7±14.3 days. Pneumonia (25.3±28.8 days, p<0.001), urinary tract infection (32.9±45.2 days, p<0.001) and malignant stroke (29.1±21.4 days, p<0.001) increased significantly the length of hospital stay compared to patients without any complications (11.2±7.1 days).
Conclusion:
this study showed that three complications delayed hospital discharge in patients admitted in a stroke unit, two preventable ones: pneumonia and urinary tract infection. More intense measures to avoid them should be included in the performance indicators to reduce the length of hospital stay in stroke units.
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