Abstract

Factors Predicting Length of Hospital Stay in Acute Stroke Patients Admitted in a Rural Tertiary Care Hospital

Amrish Saxena *,Ram Nandan Prasad ,Khushboo Verma ,Shilpa Saxena

Background: Cerebrovascular stroke is a global health problem. Prolonged length of hospital stay following stroke inflates health care cost, increases risk for hospital-acquired complications, in-hospital death and has been associated with worse outcome. Methods: A hospital based prospective study was performed in acute stroke patients admitted in the department of Medicine of a rural teaching tertiary care hospital located in a town in central India. Data of all consecutive stroke inpatients related to demographic variables (age, gender, social class, education-status), co-morbid conditions, risk factors, imaging variables and various complications during hospital course was collected from patients’ medical records. The type, location, and side of the stroke lesion were noted from the CT/MRI head reports of stroke patients. Stroke assessment scales (GCS, NIHSS, mRS) were also assessed by another trained study person who was blind of the diagnosis and investigations of the patient. Results: A total of 55 stroke patients were studied. The mean age was 58.4 + 12 years; ranging from 23-86 years. Of the total 55 stroke patients, 32 (58.2%) were males and 23 (41.8%) were females. Twenty three (41.8%) of 55 stroke patients had length of stay (LOS) in hospital ≥7 days. The association of location of stroke lesion (LAC/TAC/PAC/POC) and GCS score with LOS in hospital was found to be statistically significant (P<0.05). During hospitalization, six patients developed pressure-sore and five patients developed sepsis, all of them had prolonged LOS in hospital (>7days). Conclusion: Prolonged length of stay (>7 days) in hospitalized stroke patients was related to location of lesions and low Glasgow coma scale scores. The complications during hospitalization esp. pressure-sores and sepsis were associated with prolonged length of stay in hospitalized stroke patients.