Determinants of Length of Stay following Total Anterior Circulatory Stroke

James P. Curtain, Man Yu, Allan B. Clark, Nicholas D. Gollop, Joao H. Bettencourt-Silva, Anthony Kneale Metcalf, Kristian M. Bowles, Marcus D. Flather, John F. Potter, Phyo Kyaw Myint

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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.
Original languageEnglish
Article number26
Pages (from-to)1-9
Number of pages9
JournalGeriatrics
Volume2
Issue number3
Early online date4 Aug 2017
DOIs
Publication statusPublished - Sep 2017

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Length of Stay
Stroke
Heart Failure
Resource Allocation
Patient Discharge
Transient Ischemic Attack
Registries
Delivery of Health Care
Mortality

Keywords

  • haemorrhagic stroke
  • ischaemic stroke
  • length of stay
  • mortality
  • total anterior circulatory stroke

Cite this

Curtain, J. P., Yu, M., Clark, A. B., Gollop, N. D., Bettencourt-Silva, J. H., Metcalf, A. K., ... Myint, P. K. (2017). Determinants of Length of Stay following Total Anterior Circulatory Stroke. Geriatrics, 2(3), 1-9. [26]. https://doi.org/10.3390/geriatrics2030026

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.; Myint, Phyo Kyaw.

In: Geriatrics, Vol. 2, No. 3, 26, 09.2017, p. 1-9.

Research output: Contribution to journalArticle

Curtain, JP, Yu, M, Clark, AB, Gollop, ND, Bettencourt-Silva, JH, Metcalf, AK, Bowles, KM, Flather, MD, Potter, JF & Myint, PK 2017, 'Determinants of Length of Stay following Total Anterior Circulatory Stroke', Geriatrics, vol. 2, no. 3, 26, pp. 1-9. https://doi.org/10.3390/geriatrics2030026
Curtain JP, Yu M, Clark AB, Gollop ND, Bettencourt-Silva JH, Metcalf AK et al. Determinants of Length of Stay following Total Anterior Circulatory Stroke. Geriatrics. 2017 Sep;2(3):1-9. 26. https://doi.org/10.3390/geriatrics2030026
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. ; Myint, Phyo Kyaw. / Determinants of Length of Stay following Total Anterior Circulatory Stroke. In: Geriatrics. 2017 ; Vol. 2, No. 3. pp. 1-9.
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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.",
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AU - Metcalf, Anthony Kneale

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