scholarly journals Impact of Preexisting Depression on Length of Stay and Discharge Destination Among Patients Hospitalized for Acute Stroke

Stroke ◽  
2008 ◽  
Vol 39 (1) ◽  
pp. 132-138 ◽  
Author(s):  
Jasper Nuyen ◽  
Peter M. Spreeuwenberg ◽  
Peter P. Groenewegen ◽  
Geertrudis A.M. van den Bos ◽  
François G. Schellevis
Keyword(s):  
Length Of Stay ◽  
Acute Stroke ◽  
Discharge Destination

Abstract 1122‐000067: Radial Versus Femoral Artery Access for Mechanical Thrombectomy Following IV tPA Administration

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Joshua S Catapano ◽  
Andrew Ducruet ◽  
Felipe C Albuquerque ◽  
Ashutosh Jadhav
Keyword(s):  
Length Of Stay ◽  
Acute Stroke ◽  
Mechanical Thrombectomy ◽  
Average Length ◽  
Linear Regression Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Access Site ◽  
Femoral Access ◽  
Iv Tpa

Introduction : The transradial artery (TRA) approach for neuroendovascular procedures has been demonstrated as a safe and effective alternative to the transfemoral artery (TFA) approach. The present study compares the efficiency and periprocedural outcomes of the TRA and TFA approach for acute stroke interventions in patients receiving intravenous alteplase. Methods : The study was designed as a retrospective analysis of patients who underwent acute mechanical thrombectomy at a large cerebrovascular center between January 2014 and March 2021. Intervention cohorts (TRA and TFA) were compared on baseline characteristics, periprocedural efficiency/efficacy, and in‐hospital outcomes. Results : A total of 314 patients underwent acute mechanical thrombectomy following IV tPA via TRA (6.7%, 21/314) or TFA (93.3%, 293/314) approach. The overall complication rate appeared higher in TFA (6.8%, 20/314) compared to TRA (4.8%,1/21) patients. Access site complications were present in 4.1%(12/293) of TFA patients and 0.0%(0/21) of TRA patients. The average length of stay (days ± standard deviation) was significantly greater in TFA (8.8 ± 8.5) vs. TRA (4.8 ± 2.9) patients (P = 0.02). Linear regression analysis found femoral access (p = 0.046), Medicaid (p = 0.004) insurance, and discharge NIHSS >10 (p = 0.045) as predictors of increased length of stay. However, when time to initial physical/occupation session was added to the model, access site was no longer significant. Conclusions : The TRA (vs. TFA) approach for acute stroke interventions following IV tPA administration may potentially reduce periprocedural complications and hospital length of stay. The reduction in length of stay with TRA access appears to be associated with earlier initiation of therapies.

scholarly journals Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke

2018 ◽  
Vol 15 (11) ◽  
pp. 2532 ◽  
Author(s):  
Richard Ofori-Asenso ◽  
Ella Zomer ◽  
Ken Chin ◽  
Si Si ◽  
Peter Markey ◽  
...  
Keyword(s):  
Older Adults ◽  
Length Of Stay ◽  
Acute Stroke ◽  
Charlson Comorbidity Index ◽  
Negative Binomial ◽  
Cox Regression ◽  
Negative Binomial Regression ◽  
Tertiary Hospital ◽  
Hospital Death ◽  
Comorbidity Index

The burden of comorbidity among stroke patients is high. The aim of this study was to examine the effect of comorbidity on the length of stay (LOS), costs, and mortality among older adults hospitalised for acute stroke. Among 776 older adults (mean age 80.1 ± 8.3 years; 46.7% female) hospitalised for acute stroke during July 2013 to December 2015 at a tertiary hospital in Melbourne, Australia, we collected data on LOS, costs, and discharge outcomes. Comorbidity was assessed via the Charlson Comorbidity Index (CCI), where a CCI score of 0–1 was considered low and a CCI ≥ 2 was high. Negative binomial regression and quantile regression were applied to examine the association between CCI and LOS and cost, respectively. Survival was evaluated with the Kaplan–Meier and Cox regression analyses. The median LOS was 1.1 days longer for patients with high CCI than for those with low CCI. In-hospital mortality rate was 18.2% (22.1% for high CCI versus 11.8% for low CCI, p < 0.0001). After controlling for confounders, high CCI was associated with longer LOS (incidence rate ratio [IRR]; 1.35, p < 0.0001) and increased likelihood of in-hospital death (hazard ratio [HR]; 1.91, p = 0.003). The adjusted median, 25th, and 75th percentile costs were AUD$2483 (26.1%), AUD$1446 (28.1%), and AUD$3140 (27.9%) higher for patients with high CCI than for those with low CCI. Among older adults hospitalised for acute stroke, higher global comorbidity (CCI ≥ 2) was associated adverse clinical outcomes. Measures to better manage comorbidities should be considered as part of wider strategies towards mitigating the social and economic impacts of stroke.

Abstract T P113: Orpington Prognostic Scale: A Predictive Tool for Discharge Outcome in a Hyper Acute Stroke Unit

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Sushmita Mohapatra ◽  
Amy M Jones
Keyword(s):  
Acute Stroke ◽  
Predictive Value ◽  
Stroke Unit ◽  
Predictive Ability ◽  
Inpatient Setting ◽  
Discharge Destination ◽  
Predictive Tool ◽  
Co Morbidity ◽  
Acute Stroke Unit ◽  
Rehabilitation Needs

Introduction: An accurate assessment of the severity of impairment and prediction of prognosis following stroke is important for determining rehabilitation needs of stroke patients. The study investigated the predictive ability of the Orpington Prognostic Scale (OPS) administered within 72 hours of stroke onset, in determining discharge destination post admission to a Hyper Acute Stroke Unit (HASU) in the United Kingdom. Method: Prospective analysis of OPS data were collected from 247 patients with confirmed diagnosis of stroke admitted to HASU. OPS scores were recorded between 0 to 72hours of admission and compared to discharge destination at 72 hours. Predictive ability of the tool and association with other variables were analysed using logistic regression and multivariate analysis. Results: Low OPS score (<3.2) had high positive predictive value (PPV 88.63%)for discharge home and high OPS score (>3.2) had high predictive value (PPV 98.39) for patients requiring further inpatient rehabilitation. OPS had high specificity and sensitivity for the above, independent of age, gender, type and site of stroke, stroke severity, previous social support and co-morbidity. Conclusions: OPS could be a valuable tool in predicting the discharge destination from a HASU and thereby facilitate the identification of early rehabilitation needs, 72 hours post stroke by predicting the need for further management. OPS < 3.2 were highly likely to go home with or without support/therapy. Whereas OPS > 3.2 were highly likely to require further medical/therapy input in an inpatient setting.

scholarly journals Machine learning models to predict length of stay and discharge destination in complex head and neck surgery

Head & Neck ◽  
2020 ◽  
Author(s):  
Khodayar Goshtasbi ◽  
Tyler M. Yasaka ◽  
Mehdi Zandi‐Toghani ◽  
Hamid R. Djalilian ◽  
William B. Armstrong ◽  
...  
Keyword(s):  
Machine Learning ◽  
Length Of Stay ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Discharge Destination ◽  
Learning Models ◽  
Machine Learning Models
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