Prognostic factors for discharge destination after acute stroke: a comprehensive literature review

Abstract

Purpose: In the future, budget constraints will make efficient care for stroke patients more important. The cost of hospitalization for stroke is high. It is desirable to consider a patient’s discharge destination soon after onset and thereby screen patients for further care. This study aims to review the evidence of factors that determine discharge destinations after acute phase of stroke in adult patients. Methods: The systematic literature search was performed in seven databases. This systematic review was conducted by the preferred reporting items for systematic reviews and meta-analyses (PRISMA statement). Full-text articles were included and assessed for methodological quality by two independent researchers. Results: Eighteen articles were selected that demonstrate factors defining discharge destination. Younger age, good post-stroke admission to a teaching hospital, and a number of medical factors are determinants to a favorable discharge destination. Determinants for unfavorable discharge destinations were a severe stroke, high body mass index, alcohol abuse, statin withdrawal during hospitalization, the presence of comorbidities like respiratory failure and dementia or having a Medicaid insurance. Conclusion: Patient initial medical care, age and sex, neurological and medical complications and environmental/socio-economic factors should be considered in the decision-making process for discharge destination.

Implications for Rehabilitation

• Systematic screening for prognostic factors may improve discharge planning.

• Discharge destination to home may be predicted by a number of factors including a young age, being Caucasian, having few medical comorbidities, achieving a physical and cognitive level of independence and being admitted to a teaching hospital, having an insurance may also play a role.

• Cerebrovascular disorders
• discharge destination
• stroke

Declaration of interest

The authors report no conflict of interest.