Variable lengths of stay among ischemic stroke subtypes in Chinese general teaching hospitals

PLoS One. 2012;7(9):e45101. doi: 10.1371/journal.pone.0045101. Epub 2012 Sep 28.

Abstract

Background: Length 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 findings: Using 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.

Conclusions: LOS 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / classification*
  • Brain Ischemia / epidemiology*
  • Cerebral Infarction / epidemiology
  • China / epidemiology
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitals, General / statistics & numerical data*
  • Hospitals, Teaching / statistics & numerical data*
  • Humans
  • International Classification of Diseases
  • Length of Stay*
  • Male
  • Middle Aged
  • Stroke / classification*
  • Stroke / epidemiology*

Grant support

This work is supported, in part, by the “985” Project from Ministry of Education of China. No additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.