Length of Hospital Stay After Stroke: A Korean Nationwide Study

Abstract

ObjectiveTo investigate the length of hospital stay (LOS) after stroke using the database of the Korean Health Insurance Review & Assessment Service.MethodsWe matched the data of patients admitted for ischemic stroke onset within 7 days in the Departments of Neurology of 12 hospitals to the data from the database of the Korean Health Insurance Review & Assessment Service. We recruited 3,839 patients who were hospitalized between January 2011 and December 2011, had a previous modified Rankin Scale of 0, and no acute hospital readmission after discharge. The patients were divided according to the initial National Institute of Health Stroke Scale score (mild, ≤5; moderate, >5 and ≤13; severe, >13); we compared the number of hospitals that admitted patients and LOS after stroke according to severity, age, and sex.ResultsThe mean LOS was 115.6±219.0 days (median, 19.4 days) and the mean number of hospitals was 3.3±2.1 (median, 2.0). LOS was longer in patients with severe stroke (mild, 65.1±146.7 days; moderate, 223.1±286.0 days; and severe, 313.2±336.8 days). The number of admitting hospitals was greater for severe stroke (mild, 2.9±1.7; moderate, 4.3±2.6; and severe, 4.5±2.4). LOS was longer in women and shorter in patients less than 65 years of age.ConclusionLOS after stroke differed according to the stroke severity, sex, and age. These results will be useful in determining the appropriate LOS after stroke in the Korean medical system.

Association Between Postoperative Mini-Balance Evaluation Systems Test Scores and Length of Hospital Stay in Patients with Chronic Subdural Hematoma: A Prospective Cohort Study

“…In this study, a positive correlation was observed between initial NIHSS and LOS in patients after surgery for CSDH. This finding is consistent with those of previous studies in patients with stroke (Chang et al, 2002; Kang et al, 2016) and suggests that neurological severity may influence LOS. However, in a study of patients with stroke (Chang et al, 2002), the median NIHSS score was 6, with 56% of patients classified as having mild neurological impairment (NIHSS score <7) and 44% as having moderate or greater impairment (NIHSS score ≥7).…”

Association Between Postoperative Mini-Balance Evaluation Systems Test Scores and Length of Hospital Stay in Patients with Chronic Subdural Hematoma: A Prospective Cohort Study

“…In this study, a positive correlation was observed between initial NIHSS and LOS in patients after surgery for CSDH. This finding is consistent with those of previous studies in patients with stroke (Chang et al, 2002; Kang et al, 2016) and suggests that neurological severity may influence LOS. However, in a study of patients with stroke (Chang et al, 2002), the median NIHSS score was 6, with 56% of patients classified as having mild neurological impairment (NIHSS score <7) and 44% as having moderate or greater impairment (NIHSS score ≥7).…”

How health risk factors affect inpatient costs among adults with stroke in China: the mediating role of length of stay

“…In our study, 36.94% of the patients suffered from cerebral haemorrhage, and the inpatient costs increased because of the acute onset and increased complications. In terms of sex, the inpatient costs for female patients were higher than those for male patients, which was consistent with a Korean nationwide study; females might have a longer LOS than males, and the cost of treatment was higher [ 39 ].…”

Comparison of hospital length of stay of acute ischemic stroke patients with non-valvular atrial fibrillation started on rivaroxaban or warfarin treatment during hospitalization

“…In addition, from a clinical perspective, the subgroup analysis according to SSI was performed as SSI included some important known confounders, and that we suspected the presence of heterogeneity on LOS-OAC according to SSI level. The result of the subgroup analysis according to SSI after IPTW adjustment showed that regardless of drug selection, patients with mild stroke were more likely to have shorter LOS-OAC than those with a moderate or severe stroke which corroborated the previous finding that stroke severity is a significant predictor of LOS 26,27 . Regarding the comparison between the drugs, the LOS-OAC was similar between rivaroxaban and warfarin users in patients with severe stroke whilst rivaroxaban users had a 4-day shorter LOS-OAC than warfarin users in the mild stroke severity subgroup, and a 5-day shorter LOS-OAC in the moderate stroke severity subgroup.…”

Association Between Postoperative Mini-Balance Evaluation Systems Test Scores and Length of Hospital Stay in Patients with Chronic Subdural Hematoma: A Prospective Cohort Study

“…In this study, a positive correlation was observed between initial NIHSS and LOS in patients after surgery for CSDH. This finding is consistent with those of previous studies in patients with stroke (Chang et al, 2002; Kang et al, 2016) and suggests that neurological severity may influence LOS. However, in a study of patients with stroke (Chang et al, 2002), the median NIHSS score was 6, with 56% of patients classified as having mild neurological impairment (NIHSS score <7) and 44% as having moderate or greater impairment (NIHSS score ≥7).…”

How health risk factors affect inpatient costs among adults with stroke in China: the mediating role of length of stay

“…In our study, 36.94% of the patients suffered from cerebral haemorrhage, and the inpatient costs increased because of the acute onset and increased complications. In terms of sex, the inpatient costs for female patients were higher than those for male patients, which was consistent with a Korean nationwide study; females might have a longer LOS than males, and the cost of treatment was higher [ 39 ].…”

Comparison of hospital length of stay of acute ischemic stroke patients with non-valvular atrial fibrillation started on rivaroxaban or warfarin treatment during hospitalization

“…In addition, from a clinical perspective, the subgroup analysis according to SSI was performed as SSI included some important known confounders, and that we suspected the presence of heterogeneity on LOS-OAC according to SSI level. The result of the subgroup analysis according to SSI after IPTW adjustment showed that regardless of drug selection, patients with mild stroke were more likely to have shorter LOS-OAC than those with a moderate or severe stroke which corroborated the previous finding that stroke severity is a significant predictor of LOS 26,27 . Regarding the comparison between the drugs, the LOS-OAC was similar between rivaroxaban and warfarin users in patients with severe stroke whilst rivaroxaban users had a 4-day shorter LOS-OAC than warfarin users in the mild stroke severity subgroup, and a 5-day shorter LOS-OAC in the moderate stroke severity subgroup.…”

Association Between Postoperative Mini-Balance Evaluation Systems Test Scores and Length of Hospital Stay in Patients with Chronic Subdural Hematoma: A Prospective Cohort Study

“…In this study, a positive correlation was observed between initial NIHSS and LOS in patients after surgery for CSDH. This finding is consistent with those of previous studies in patients with stroke (Chang et al, 2002; Kang et al, 2016) and suggests that neurological severity may influence LOS. However, in a study of patients with stroke (Chang et al, 2002), the median NIHSS score was 6, with 56% of patients classified as having mild neurological impairment (NIHSS score <7) and 44% as having moderate or greater impairment (NIHSS score ≥7).…”

How health risk factors affect inpatient costs among adults with stroke in China: the mediating role of length of stay

“…In our study, 36.94% of the patients suffered from cerebral haemorrhage, and the inpatient costs increased because of the acute onset and increased complications. In terms of sex, the inpatient costs for female patients were higher than those for male patients, which was consistent with a Korean nationwide study; females might have a longer LOS than males, and the cost of treatment was higher [ 39 ].…”

Comparison of hospital length of stay of acute ischemic stroke patients with non-valvular atrial fibrillation started on rivaroxaban or warfarin treatment during hospitalization

“…In addition, from a clinical perspective, the subgroup analysis according to SSI was performed as SSI included some important known confounders, and that we suspected the presence of heterogeneity on LOS-OAC according to SSI level. The result of the subgroup analysis according to SSI after IPTW adjustment showed that regardless of drug selection, patients with mild stroke were more likely to have shorter LOS-OAC than those with a moderate or severe stroke which corroborated the previous finding that stroke severity is a significant predictor of LOS 26,27 . Regarding the comparison between the drugs, the LOS-OAC was similar between rivaroxaban and warfarin users in patients with severe stroke whilst rivaroxaban users had a 4-day shorter LOS-OAC than warfarin users in the mild stroke severity subgroup, and a 5-day shorter LOS-OAC in the moderate stroke severity subgroup.…”