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Geriatrics 2017, 2(3), 26; doi:10.3390/geriatrics2030026

Determinants of Length of Stay Following Total Anterior Circulatory Stroke

1
Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
2
Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
3
Clinical Informatics, Department of Medicine, University of Cambridge, Cambridge CB2 1TN, UK
4
Stroke Research Group, Stroke Services, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
*
Author to whom correspondence should be addressed.
Received: 10 June 2017 / Revised: 25 July 2017 / Accepted: 29 July 2017 / Published: 4 August 2017
(This article belongs to the Special Issue Stroke in Ageing)
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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. View Full-Text
Keywords: haemorrhagic stroke; ischaemic stroke; length of stay; mortality; total anterior circulatory stroke haemorrhagic stroke; ischaemic stroke; length of stay; mortality; total anterior circulatory stroke
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Curtain, J.P.; Yu, M.; Clark, A.B.; Gollop, N.D.; Bettencourt-Silva, J.H.; Metcalf, A.K.; Bowles, K.M.; Flather, M.D.; Potter, J.F.; Myint, P.K. Determinants of Length of Stay Following Total Anterior Circulatory Stroke. Geriatrics 2017, 2, 26.

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