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Derivation and validation of the prolonged length of stay score in acute stroke patients.
Neurology. 2010 May 11; 74(19):1511-6.Neur

Abstract

BACKGROUND

Length of stay (LOS) is the main cost-determining factor of hospitalization of stroke patients. Our aim was to derive and validate a simple score for the assessment of the risk of prolonged LOS for acute stroke patients in a national setting.

METHODS

Ischemic stroke (IS) and intracerebral hemorrhage (ICH) patients in the National Acute Stroke Israeli Surveys (NASIS 2004 and 2007) were included. Predictors of prolonged LOS (LOS > or =7 days) in the NASIS 2004 (n = 1,700) were identified with logistic regression analysis and used for the derivation of the Prolonged Length of Stay (PLOS) score. The score was validated in the NASIS 2007 (n = 1,648).

RESULTS

Median (interquartile range) LOS was 6 (3-10) days in the derivation cohort (42.3% prolonged LOS) and 5 (3-8) in the validation cohort (35.7% prolonged LOS). The derivation cohort included 54.8% men, 90.8% IS and 9.2% ICH, with a mean (SD) age of 71.2 (12.5) years. Stroke severity was the strongest multivariable predictor of prolonged LOS: odds ratio (95% confidence interval [CI]) increased from 2.6 (2.0-3.3) for NIH Stroke Scale score (NIHSS) 6-10 to 4.9 (3.0-8.0) for NIHSS 16-20, compared with NIHSS < or =5. Stroke severity and type, decreased level of consciousness on admission, history of congestive heart failure, and prior atrial fibrillation were used for the derivation of the PLOS score (c statistics 0.692, 95% CI 0.666-0.718). The score performed similarly well in the validation cohort (c statistics 0.680, 95% CI 0.653-0.707).

CONCLUSION

A simple prolonged length of stay score, based on available baseline information, may be useful for tailoring policy aimed at better use of resources and optimal discharge planning of acute stroke patients.

Authors+Show Affiliations

Stanley Steyer School of Health, Tel-Aviv University, Tel Aviv, Israel. koton@post.tau.ac.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

20458067

Citation

Koton, S, et al. "Derivation and Validation of the Prolonged Length of Stay Score in Acute Stroke Patients." Neurology, vol. 74, no. 19, 2010, pp. 1511-6.
Koton S, Bornstein NM, Tsabari R, et al. Derivation and validation of the prolonged length of stay score in acute stroke patients. Neurology. 2010;74(19):1511-6.
Koton, S., Bornstein, N. M., Tsabari, R., & Tanne, D. (2010). Derivation and validation of the prolonged length of stay score in acute stroke patients. Neurology, 74(19), 1511-6. https://doi.org/10.1212/WNL.0b013e3181dd4dc5
Koton S, et al. Derivation and Validation of the Prolonged Length of Stay Score in Acute Stroke Patients. Neurology. 2010 May 11;74(19):1511-6. PubMed PMID: 20458067.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Derivation and validation of the prolonged length of stay score in acute stroke patients. AU - Koton,S, AU - Bornstein,N M, AU - Tsabari,R, AU - Tanne,D, AU - ,, PY - 2010/5/12/entrez PY - 2010/5/12/pubmed PY - 2010/7/2/medline SP - 1511 EP - 6 JF - Neurology JO - Neurology VL - 74 IS - 19 N2 - BACKGROUND: Length of stay (LOS) is the main cost-determining factor of hospitalization of stroke patients. Our aim was to derive and validate a simple score for the assessment of the risk of prolonged LOS for acute stroke patients in a national setting. METHODS: Ischemic stroke (IS) and intracerebral hemorrhage (ICH) patients in the National Acute Stroke Israeli Surveys (NASIS 2004 and 2007) were included. Predictors of prolonged LOS (LOS > or =7 days) in the NASIS 2004 (n = 1,700) were identified with logistic regression analysis and used for the derivation of the Prolonged Length of Stay (PLOS) score. The score was validated in the NASIS 2007 (n = 1,648). RESULTS: Median (interquartile range) LOS was 6 (3-10) days in the derivation cohort (42.3% prolonged LOS) and 5 (3-8) in the validation cohort (35.7% prolonged LOS). The derivation cohort included 54.8% men, 90.8% IS and 9.2% ICH, with a mean (SD) age of 71.2 (12.5) years. Stroke severity was the strongest multivariable predictor of prolonged LOS: odds ratio (95% confidence interval [CI]) increased from 2.6 (2.0-3.3) for NIH Stroke Scale score (NIHSS) 6-10 to 4.9 (3.0-8.0) for NIHSS 16-20, compared with NIHSS < or =5. Stroke severity and type, decreased level of consciousness on admission, history of congestive heart failure, and prior atrial fibrillation were used for the derivation of the PLOS score (c statistics 0.692, 95% CI 0.666-0.718). The score performed similarly well in the validation cohort (c statistics 0.680, 95% CI 0.653-0.707). CONCLUSION: A simple prolonged length of stay score, based on available baseline information, may be useful for tailoring policy aimed at better use of resources and optimal discharge planning of acute stroke patients. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/20458067/Derivation_and_validation_of_the_prolonged_length_of_stay_score_in_acute_stroke_patients_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=20458067 DB - PRIME DP - Unbound Medicine ER -