Defining Prolonged Length of Acute Care Stay for Surgically and Conservatively Treated Patients with Spontaneous Intracerebral Hemorrhage: A Population-Based Analysis

Biomed Res Int. 2016:2016:9095263. doi: 10.1155/2016/9095263. Epub 2016 Mar 27.

Abstract

Background: The definition of prolonged length of stay (LOS) during acute care remains unclear among surgically and conservatively treated patients with intracerebral hemorrhage (ICH).

Methods: Using a population-based quality assessment registry, we calculated change points in LOS for surgically and conservatively treated patients with ICH. The influence of comorbidities, baseline characteristics at admission, and in-hospital complications on prolonged LOS was evaluated in a multivariate model.

Results: Overall, 13272 patients with ICH were included in the analysis. Surgical therapy of the hematoma was documented in 1405 (10.6%) patients. Change points for LOS were 22 days (CI: 8, 22; CL 98%) for surgically treated patients and 16 days (CI: 16, 16; CL: 99%) for conservatively treated patients. Ventilation therapy was related to prolonged LOS in surgically (OR: 2.2, 95% CI: 1.5-3.1; P < 0.001) and conservatively treated patients (OR: 2.5, 95% CI: 2.2-2.9; P < 0.001). Two or more in-hospital complications in surgical patients (OR: 2.7, 95% CI: 2.1-3.5) and ≥1 in conservative patients (OR: 3.0, 95% CI: 2.7-3.3) were predictors of prolonged LOS.

Conclusion: The definition of prolonged LOS after ICH could be useful for several aspects of quality management and research. Preventing in-hospital complications could decrease the number of patients with prolonged LOS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebral Hemorrhage / epidemiology*
  • Cerebral Hemorrhage / physiopathology
  • Cerebral Hemorrhage / surgery*
  • Demography
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Length of Stay*
  • Male
  • Middle Aged
  • Risk Factors