Abstract
BackgroundLength of stay (LOS) is one of the most important quantitative indexes that measures health service utilization within a hospital. Many studies have examined the association of three major stroke categories with LOS. Our aim is to investigate the differences of LOS among ischemic stroke subtypes, results from which are helpful to healthcare providers and government agencies to improve health care delivery efficiency.Methodology/Principal FindingsUsing the Beijing Municipal Health Bureau’s hospitalization summary reports, we performed a retrospective study among first-ever in-hospital patients with ischemic stroke (ICD-10 I63) in three general teaching hospitals in Beijing, China, from 2006 to 2010 with generalized linear model. In our study, 5,559 patients (female, 36.0%; age, 64.4±12.9 years) were included. The estimated mean LOS of ischemic stroke was 17.4±1.8 days. After adjusting for confounders, LOS of lacunar infarction (14.7 days; p<0.001) and LOS of small cerebral infarction (17.0 days; p = 0.393) were shorter than that of single cerebral infarction (17.9 days, p<0.001). LOS of multi-infarct (19.0 days; p = 0.028), brainstem infarction (19.3 days; p = 0.045), basal ganglia infarction (18.5 days; p = 0.452) and other subtypes of ischemic stroke (18.9 days; p = 0.327) were longer than that of single cerebral infarction.ConclusionsLOS of ischemic stroke patient differes across single cerebral infarction, lacunar infarction, multi-infarct and brainstem infarction patients. The ascending order of LOS was lacunar infarction, small cerebral infarction, single cerebral infarction, basal ganglia infarction, other subtypes of ischemic stroke, multi-infarct and brainstem infarction.
Highlights
Stroke is the second most common cause of death and leading cause of adult disability worldwide [1]
Because stroke often results in permanent dependence, long-term, cost-effective stroke care should be established [5], which inevitably leads to heavy use of health care resources
We considered the following potentially confounding variables: gender is potentially a confounder, since the stroke incidence differs between males and females, and so are hospitalization rates [18]
Summary
Stroke is the second most common cause of death and leading cause of adult disability worldwide [1]. In the United States, stroke ranks number 4 among all causes of death, behind the heart diseases, cancer, and chronic lower respiratory disease [4]. Because stroke often results in permanent dependence, long-term, cost-effective stroke care should be established [5], which inevitably leads to heavy use of health care resources. These resources are typically measured by the length of stay (LOS), which is probably one of the most important quantitative indexes that measures health service utilization within a hospital. Our aim is to investigate the differences of LOS among ischemic stroke subtypes, results from which are helpful to healthcare providers and government agencies to improve health care delivery efficiency
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