Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke

Narongrit Kasemsap,1,2 Nisa Vorasoot,1,2 Kannikar Kongbunkiat,1,2 Udomlack Peansukwech,1 Somsak Tiamkao,1,2 Kittisak Sawanyawisuth1,3,4 1Department of Medicine, Faculty of Medicine, 2North-Eastern Stroke Research Group, 3Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH)...

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Autores principales:	Kasemsap N, Vorasoot N, Kongbunkiat K, Peansukwech U, Tiamkao S, Sawanyawisuth K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	acute ischemic stroke length of stay thrombolysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/92369a40d90b476b898385afad5e57c9
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spelling	oai:doaj.org-article:92369a40d90b476b898385afad5e57c92021-12-02T06:03:12ZImpact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke1178-2021https://doaj.org/article/92369a40d90b476b898385afad5e57c92018-01-01T00:00:00Zhttps://www.dovepress.com/impact-of-intravenous-thrombolysis-on-length-of-hospital-stay-in-cases-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Narongrit Kasemsap,1,2 Nisa Vorasoot,1,2 Kannikar Kongbunkiat,1,2 Udomlack Peansukwech,1 Somsak Tiamkao,1,2 Kittisak Sawanyawisuth1,3,4 1Department of Medicine, Faculty of Medicine, 2North-Eastern Stroke Research Group, 3Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), 4Internal Medicine Research Group, Khon Kaen University, Khon Kaen, Thailand Background: There are limited data available on factors associated with length of stay (LOS) in cases of acute ischemic stroke according to Poisson analysis, which is more appropriate than other methods.Materials and methods: We retrospectively reviewed medical summary charts of patients with acute ischemic stroke in 30 hospitals across northeast Thailand, with the main outcome as LOS. Poisson regression was used to examine factors associated with LOS.Results: We included 898 patients in the analysis; 460 (51.2%) were male. The median age (interquartile; IQR) was 58 (67–75) years and the median LOS was 5 (4–7) days. The median National Institute of Health Stroke Scale (NIHSS [IQR]) was 8 (4–13). Results of the analysis showed that, after controlling for age, stroke severity, atrial fibrillation, and thrombolytic use, significant variables associated with LOS were moderate stroke (incidence rate ratio [IRR] 95% confidence interval [CI] =1.15 [range 1.01–1.30], P=0.040), severe stroke (IRR [95% CI] =1.27 [1.09–1.47], P=0.002), thrombolytic use (IRR [95% CI] =0.68 [0.60–0.76], P<0.001), and atrial fibrillation (IRR [95% CI] =1.15 [1.02–1.30], P=0.023). After adjusting for complications, thrombolytic use remained significantly associated with decreased LOS (IRR [95% CI] =0.74 [0.67–0.83], P=0.001). Other significant factors were atrial fibrillation (IRR [95% CI] =1.14 [1.02–1.28], P=0.018), pneumonia (IRR [95% CI] =1.48 [1.30–1.68], P<0.001), and urinary tract infection (IRR [95% CI] =1.41 [1.14–1.74], P=0.001).Conclusion: According to Poisson analysis, intravenous thrombolysis, atrial fibrillation, pneumonia, and urinary tract infection are associated with LOS in cases of acute ischemic stroke, regardless of age, stroke severity, comorbidities, or complications. Keywords: acute ischemic stroke, length of stay, thrombolysisKasemsap NVorasoot NKongbunkiat KPeansukwech UTiamkao SSawanyawisuth KDove Medical Pressarticleacute ischemic strokelength of staythrombolysisNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 259-264 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute ischemic stroke length of stay thrombolysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	acute ischemic stroke length of stay thrombolysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kasemsap N Vorasoot N Kongbunkiat K Peansukwech U Tiamkao S Sawanyawisuth K Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke
description	Narongrit Kasemsap,1,2 Nisa Vorasoot,1,2 Kannikar Kongbunkiat,1,2 Udomlack Peansukwech,1 Somsak Tiamkao,1,2 Kittisak Sawanyawisuth1,3,4 1Department of Medicine, Faculty of Medicine, 2North-Eastern Stroke Research Group, 3Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), 4Internal Medicine Research Group, Khon Kaen University, Khon Kaen, Thailand Background: There are limited data available on factors associated with length of stay (LOS) in cases of acute ischemic stroke according to Poisson analysis, which is more appropriate than other methods.Materials and methods: We retrospectively reviewed medical summary charts of patients with acute ischemic stroke in 30 hospitals across northeast Thailand, with the main outcome as LOS. Poisson regression was used to examine factors associated with LOS.Results: We included 898 patients in the analysis; 460 (51.2%) were male. The median age (interquartile; IQR) was 58 (67–75) years and the median LOS was 5 (4–7) days. The median National Institute of Health Stroke Scale (NIHSS [IQR]) was 8 (4–13). Results of the analysis showed that, after controlling for age, stroke severity, atrial fibrillation, and thrombolytic use, significant variables associated with LOS were moderate stroke (incidence rate ratio [IRR] 95% confidence interval [CI] =1.15 [range 1.01–1.30], P=0.040), severe stroke (IRR [95% CI] =1.27 [1.09–1.47], P=0.002), thrombolytic use (IRR [95% CI] =0.68 [0.60–0.76], P<0.001), and atrial fibrillation (IRR [95% CI] =1.15 [1.02–1.30], P=0.023). After adjusting for complications, thrombolytic use remained significantly associated with decreased LOS (IRR [95% CI] =0.74 [0.67–0.83], P=0.001). Other significant factors were atrial fibrillation (IRR [95% CI] =1.14 [1.02–1.28], P=0.018), pneumonia (IRR [95% CI] =1.48 [1.30–1.68], P<0.001), and urinary tract infection (IRR [95% CI] =1.41 [1.14–1.74], P=0.001).Conclusion: According to Poisson analysis, intravenous thrombolysis, atrial fibrillation, pneumonia, and urinary tract infection are associated with LOS in cases of acute ischemic stroke, regardless of age, stroke severity, comorbidities, or complications. Keywords: acute ischemic stroke, length of stay, thrombolysis
format	article
author	Kasemsap N Vorasoot N Kongbunkiat K Peansukwech U Tiamkao S Sawanyawisuth K
author_facet	Kasemsap N Vorasoot N Kongbunkiat K Peansukwech U Tiamkao S Sawanyawisuth K
author_sort	Kasemsap N
title	Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke
title_short	Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke
title_full	Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke
title_fullStr	Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke
title_full_unstemmed	Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke
title_sort	impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/92369a40d90b476b898385afad5e57c9
work_keys_str_mv	AT kasemsapn impactofintravenousthrombolysisonlengthofhospitalstayincasesofacuteischemicstroke AT vorasootn impactofintravenousthrombolysisonlengthofhospitalstayincasesofacuteischemicstroke AT kongbunkiatk impactofintravenousthrombolysisonlengthofhospitalstayincasesofacuteischemicstroke AT peansukwechu impactofintravenousthrombolysisonlengthofhospitalstayincasesofacuteischemicstroke AT tiamkaos impactofintravenousthrombolysisonlengthofhospitalstayincasesofacuteischemicstroke AT sawanyawisuthk impactofintravenousthrombolysisonlengthofhospitalstayincasesofacuteischemicstroke
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Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke

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