Renal dysfunction is associated with lower odds of home discharge for patients with stroke

ABSTRACT

Objectives

Studies on the association of estimated glomerular filtration rate (eGFR) levels with hospital discharge disposition after stroke are limited with inconsistent results. This study investigated the odds of home discharge with eGFR levels at admission for patients with stroke using the Taiwan Stroke Registry (TSR) data.

Methods

From the TSR database, a total of 51,338 stroke patients from 2006 to 2015 were categorized into five groups based on eGFR levels at admission. The proportion of home discharge by the eGFR levels was calculated and logistic regression analysis was used to estimate the related odds ratio (OR) and 95% confidence interval.

Results

Near 85% of stroke patients were discharged to home. The proportion of home discharges decreased as the eGFR level declined. Compared to patients with eGFR ≥90 mL/min/1.73 m², the adjusted ORs of home discharge were 0.91, 0.85, 0.63, 0.56 for patients with eGFR 60–89, eGFR 30–59, eGFR 15–29, and eGFR < 15 mL/min/1.73 m² or on dialysis, respectively, in a graded relationship. The trends were consistent in the ischemic stroke and hemorrhagic stroke patients. The areas under the receiver operating characteristic curve for all stroke patients, ischemic stroke patients, and hemorrhagic stroke patients were 0.801, 0799, 0.815, respectively.

Conclusion

The odds of home discharge for stroke patients decreased with a significant independent graded association with declining eGFR levels. Renal function could predict home discharge after stroke.

KEYWORDS:

• Estimated glomerular filtration rate
• hospital discharge disposition
• renal function
• stroke

Acknowledgments

The authors are grateful to Taiwan Stroke Registry investigators for participating in data collection, and the Health Data Science Center, and China Medical University Hospital for providing administrative, technical, and funding support.

Author contributions

IKW, TMY, THY, LTC, LML, YS, CYW, KCH, and PCL contributed to study design, analysis, and drafting of the manuscript. PCL, CYL, FCS, and CYH contributed to the study design and revision of the manuscript. All authors read and approved the final manuscript.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Declaration of financial/ other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership, or options, expert testimony, grants, or patents received or pending, or royalties. Peer reviewers in this manuscript have no relevant financial or other relationships to disclose

Declaration of interest

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This study is supported in part by the Ministry of Health and Welfare, Taiwan under grant number MOHW109-TDU-B-212-114,004, China Medical University Hospital under grant number DMR 110-200, DMR-110-037 and DMR-109-175, Academia Sinica Stroke Biosignature Project under grant number BM10701010021, MOST Clinical Trial Consortium for Stroke under grant number MOST 107-2321-B-039-004, Tseng-Lien Lin Foundation, Taichung, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.