Clinical Outcomes and Medical Costs of Hydration Therapy with Hydroxyethyl Starch (130/0.4) or Acute Single Infarction

J Stroke Cerebrovasc Dis. 2021 May;30(5):105705. doi: 10.1016/j.jstrokecerebrovasdis.2021.105705. Epub 2021 Mar 10.


Objectives: To investigate the effects of hydration with or without Hydroxyethyl Starch (HES) 130/0.4 on neurological outcomes and medical costs during hospitalisation in patients with a single infarction (SI) in the posterior lenticulostriate artery (LSA) territory.

Materials and methods: In this retrospective, single-centre, non-blinded cohort study, SI in the posterior LSA was defined as an ischaemic lesion with a high-signal intensity area ≥20 mm. All patients received basic stroke care within 48 h of symptom onset between April 2015 and January 2019. Patients were divided into the following two groups by clinician's preference: 1) those administered HES 130/0.4 and 2) those receiving other infusion fluid. The relationships between hospital costs and hydration therapy type were examined.

Results: Eighteen (31%) of 58 patients received HES 130/0.4. The HES group had a significantly lower total cost than the control group (3.6 vs. 6.4 million yen, p=0.006). Moreover, the HES group had a significantly shorter hospital stay duration (79.5 vs. 141.0 days) and lower National Institutes of Health Stroke Scale score on day 7. Multivariate analysis found that HES 130/0.4 administration was an independent factor associated with high costs.

Conclusions: Hydration therapy with HES 130/0.4 significantly decreased the total costs and hospitalisation duration of patients with SI in the posterior LSA territory.

Keywords: Haemodilution; Hydration therapy; Hydroxyethyl Starch 130/0.4; Lenticulostriate artery territory; Progressive motor deficit; Stroke.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Brain Infarction / diagnosis
  • Brain Infarction / economics*
  • Brain Infarction / therapy*
  • Cost Savings
  • Cost-Benefit Analysis
  • Female
  • Fluid Therapy / adverse effects
  • Fluid Therapy / economics*
  • Hospital Costs*
  • Humans
  • Hydroxyethyl Starch Derivatives / adverse effects
  • Hydroxyethyl Starch Derivatives / economics*
  • Hydroxyethyl Starch Derivatives / therapeutic use*
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care / economics*
  • Plasma Substitutes / adverse effects
  • Plasma Substitutes / economics*
  • Plasma Substitutes / therapeutic use*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome


  • Hydroxyethyl Starch Derivatives
  • Plasma Substitutes