Predictors of Hospital Stay After Acute Ischemic Stroke in Hospitalized Patients: Retrospective-Cohort Study.

Abstract

Background: The length of hospital stay (LOS) is frequently recognized as an indicator of hospital management efficiency and the quality of care. Patients with acute ischemic stroke (AIS) who experience prolonged LOS are at a higher risk of developing complications such as hospital-acquired infections and gastrointestinal bleeding. These complications can adversely affect clinical outcomes, acting as a primary determinant of poor functional outcomes. However, evidence regarding predictors of the LOS after AIS in Ethiopia is lacking. Objective: Therefore, the objective of this study was to assess clinical predictors of the LOS after AIS among patients admitted to Tibebe Ghion and Felege Hiwot Comprehensive Specialized Hospitals. Methods: A retrospective cohort study was conducted among patients diagnosed with AIS and treated at Tibebe Ghion and Felege Hiwot hospitals from November 2018 to November 2021. Multivariate linear regression analysis was employed to explore predictors of LOS. The slope of regression line (β) with its 95% CI is used to declare statistical significance. Results: Of the 278 patients with AIS, 59.7% were male. Stroke-related complications (aspiration pneumonia and urinary tract infections occurred in the hospital in 57 (20.5%), and 12 (4.3%), patients, respectively. The most common neurological deficit observed during hospital admission was limb weakness, affecting 268 patients (96%). The median LOS was 5 days. Among the clinical characteristics, atrial fibrillation (β = 7.337, 95% CI: 1.226, 13.448), Limp weakness (β = 4.831, 95% CI: 2.330, 7.332), aspiration pneumonia (β = 2.089, 95%CI: 1.178, 3.000) and Male sex (β = 1.696, 95% CI: 0.851, 2.542), were significant predictors of LOS. Conclusion: In this study, the presence of AF and stroke-related complications, such as aspirational pneumonia, were found to be significant predictors of LOS. Therefore, implementing efficient prevention strategies targeting potentially modifiable risk factors is essential to mitigate the impact of these factors.