Which Comorbidities and Complications Predict Ischemic Stroke Recovery and Length of Stay?

Abstract

Greater age and higher National Institute of Health Stroke Scale at admission were associated with both higher disability and longer LOS. Congestive heart failure, CRF, presence of arrhythmias, and development of acute renal failure were associated with greater LOS. The development of urinary tract infection caused higher disability.

Incidence and impact on outcomes of acute kidney injury after a stroke: a systematic review and meta-analysis

“…Seven studies were considered to be of good quality and one of fair quality. The eight studies provided data on 12,325,652 patients (range 897 to 7,068,334) from four countries (five from the US [ 20 , 22 – 24 , 26 ], and one each from China [ 21 ], Greece [ 25 ] and Romania [ 19 ]). The US studies overwhelmingly had the largest sample sizes, with a total of 12,319,724 patients representing 99.9% of all included patients.…”

“…Although there are some differences in the grading of AKI severity between these classifications, both define the absolute incidence of AKI as an increase in serum creatinine > 150%. Stroke was determined using ICD coding in four studies [ 22 – 24 , 26 ]. Three studies utilized the World Health Organization (WHO) definition of stroke [ 27 ] and extracted clinical data from medical records prospectively [ 21 , 25 ] or retrospectively [ 19 ].…”

“…of subjects Age (years) (SD) Men (%) Ischemic stroke cases (%) AKI definition CKD excluded? NOS score Covic et al, 2008 [ 19 ] Observational, retrospective, Romania 1090 66.1 ± 11.5 49.3 932 (85.5%) Creatinine values; RIFLE No 7 (3, 2, 2) Khatri et al, 2014 [ 20 ] Observational, retrospective, United States 1357 64 ± 16 56.0 528 (38.9%) Creatinine values; AKIN GFR < 15 ml/min excluded 6 (2, 2, 2) Lin et al, 2011 [ 21 ] Observational, prospective, China 2683 66.1 ± 13.59 (AF), 63.58 ± 13.64 (no AF) 58.4 2683 (100%) ICD-10 coding No 7 (3, 2, 2) Mohamed et al, 2015 [ 22 ] Observational, retrospective, United States 897 64.4 ± 14.7 44.0 897 (100%) ICD-9 coding No 7 (3, 2, 2) Saeed et al, 2014 [ 23 ] Observational, retrospective, United States (Nationwide Inpatient Sample data) 7,068,334 No AKI 71 ± 31, AKI 74 ± 28 46.1 7,068,334 (100%) ICD-9 coding Yes 7 (3, 2, 2) Saeed et al, 2015 [ 24 ] Observational, retrospective, United States (Nationwide Inpatient Sample data) 614,454 No AKI 69 ± 37, AKI 68 ± 34 52.2 0 (0%) (all cases were hemorrhagic stroke) ICD-9 coding Yes 7 (3, 2, 2) Tsagalis et al, 2008 [ 25 ] Observational, prospective, Greece 2155 70.3 ± 11.9 61.2 1832 (85%) Creatinine values; AKIN …”

“…Five studies followed patients until discharge from hospital [ 20 , 22 – 24 , 26 ], one for 30 days [ 19 ], one from hospitalization up to one year [ 21 ] and one from 30 days up to 10 years [ 25 ] (Table 2 ). Two studies excluded patients with known CKD [ 23 , 24 ] and two studies excluded patients with end-stage renal disease (ESRD) [ 20 , 26 ].…”

Renal Function Predicts Outcomes in Patients with Ischaemic Stroke and Haemorrhagic Stroke

“…The length of hospitalization and in-hospital mortality was significantly longer in patients with haemorrhagic stroke than patients with ischaemic one. The recent study of Mohamed et al [28] showed that presence of CKD was associated with longer length of stay, which is the most predictive factor in determining in-patient costs.…”