Determinants of Length of Stay Following Total Anterior Circulatory Stroke

Curtain, James P, Yu, Man, Clark, Allan B, Gollop, Nicholas D, Bettencourt-Silva, Joao H, Metcalf, Anthony Kneale, Bowles, Kristian M, Flather, Marcus D, Potter, John F and Myint, Phyo Kyaw (2017) Determinants of Length of Stay Following Total Anterior Circulatory Stroke. BMC Geriatrics, 2 (3). ISSN 1471-2318

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Abstract

Identification of factors that determine length of stay (LOS) in total anterior circulatory stroke (TACS) has potential for targeted intervention to reduce the associated health care burden. This study aimed to determine which factors predict LOS following either ischaemic or haemorrhagic TACS. The study sample population was drawn from the Norfolk and Norwich Stroke and Transient Ischemic Attack (TIA) Register (1996 – 2012), a prospective registry. 2965 patients admitted with TACS verified by a stroke specialist team were included. Primary analysis identified predictors of length of stay (LOS) in either haemorrhagic or ischaemic TACS. Secondary analyses identified predictors of LOS in patients who were discharged alive or who died during admission separately. Moderate (p=0.014) to severe disability (p=0.015) and history of congestive heart failure (p=0.027) in the primary analysis and pre-stroke residence in a care facility among patients who survived to discharge (p=0.013) were associated with a shorter length of stay. Factors associated with increased length of stay included presence of neurological lateralisation in the primary analysis (p=0.004) and amongst patients who died (p=0.003 and p=0.014 for ischaemic and haemorrhagic stroke, respectively). Patients with advanced age (≥85 years) with haemorrhagic stroke had longer LOS regardless of mortality outcome. Patients with low pre-morbid disability (modified Rankin score ≤2 who died following haemorrhagic TACS also had longer LOS. Our study found predictors of LOS following TACS include neurological lateralisation, pre-stroke disability status, congestive heart failure, pre-morbid residence and age. The identification of such factors would assist in resource allocation and discharge planning.

Item Type: Article
Uncontrolled Keywords: haemorrhagic stroke,ischaemic stroke,length of stay,mortality,total anterior circulatory stroke
Faculty \ School: Faculty of Science > School of Biological Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 09 Aug 2017 05:06
Last Modified: 30 Apr 2020 23:55
URI: https://ueaeprints.uea.ac.uk/id/eprint/64399
DOI: 10.3390/geriatrics2030026

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