Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke

Abstract

Background

There are limited data available on factors associated with length of stay (LOS) in cases of acute ischemic stroke according to Poisson analysis, which is more appropriate than other methods.

Materials and methods

We retrospectively reviewed medical summary charts of patients with acute ischemic stroke in 30 hospitals across northeast Thailand, with the main outcome as LOS. Poisson regression was used to examine factors associated with LOS.

Results

We included 898 patients in the analysis; 460 (51.2%) were male. The median age (interquartile; IQR) was 58 (67–75) years and the median LOS was 5 (4–7) days. The median National Institute of Health Stroke Scale (NIHSS [IQR]) was 8 (4–13). Results of the analysis showed that, after controlling for age, stroke severity, atrial fibrillation, and thrombolytic use, significant variables associated with LOS were moderate stroke (incidence rate ratio [IRR] 95% confidence interval [CI] =1.15 [range 1.01–1.30], P=0.040), severe stroke (IRR [95% CI] =1.27 [1.09–1.47], P=0.002), thrombolytic use (IRR [95% CI] =0.68 [0.60–0.76], P<0.001), and atrial fibrillation (IRR [95% CI] =1.15 [1.02–1.30], P=0.023). After adjusting for complications, thrombolytic use remained significantly associated with decreased LOS (IRR [95% CI] =0.74 [0.67–0.83], P=0.001). Other significant factors were atrial fibrillation (IRR [95% CI] =1.14 [1.02–1.28], P=0.018), pneumonia (IRR [95% CI] =1.48 [1.30–1.68], P<0.001), and urinary tract infection (IRR [95% CI] =1.41 [1.14–1.74], P=0.001).

Conclusion

According to Poisson analysis, intravenous thrombolysis, atrial fibrillation, pneumonia, and urinary tract infection are associated with LOS in cases of acute ischemic stroke, regardless of age, stroke severity, comorbidities, or complications.

Keywords:

• acute ischemic stroke
• length of stay
• thrombolysis

Acknowledgments

The authors would like to thank Dylan Southard via the Publication Clinic at Khon Kaen University (Thailand) for proofreading this article. This work was supported by the Thailand Research Fund (TRF) and National Health Security Office (NHSO). This research was supported by the Faculty of Medicine, Khon Kaen University (grant no IN59314).

Disclosure

The authors report no conflicts of interest in this work.