From the Guidelines
Patients hospitalized for stroke complications 3 months to one year after the stroke typically require a hospital stay of approximately 5 to 14 days, depending on the complication's severity and the patient's overall health status. The duration of hospitalization can vary widely due to the diverse range of potential complications, including recurrent stroke, pneumonia, urinary tract infections, falls resulting in fractures, depression, and seizures 1. It's crucial to note that the length of stay is generally shorter than the initial stroke hospitalization but is influenced by the complexity of the complication and any underlying conditions. Key factors that can impact the length of hospitalization include:
- Severity of the complication
- Presence of multiple comorbidities
- Effectiveness of early recognition and management of complications
- Adherence to medication and rehabilitation regimens
- Regularity of medical follow-ups
According to the guidelines for the early management of patients with acute ischemic stroke by the American Heart Association/American Stroke Association 1, the importance of dedicated stroke nursing care and comprehensive management strategies cannot be overstated. These approaches are vital in preventing subacute complications, initiating long-term therapies to prevent recurrent stroke, and restoring neurological function through rehabilitation and supportive care. By prioritizing these aspects, healthcare professionals can potentially reduce both the incidence and severity of post-stroke complications, thereby shortening necessary hospitalizations.
From the Research
Hospitalization Duration for Stroke Complications
- The duration of hospitalization for stroke complications after 3 months to one year is not directly stated in the provided studies.
- However, study 2 mentions that the readmission rates were 9.7% within 30 days and 30.5% at 1 year following initial discharge, but it does not provide information on the length of hospital stay for these readmissions.
- Study 3 reports a median length of stay of 13 days for stroke unit patients, but this is for the initial hospitalization and not specifically for readmissions due to stroke complications after 3 months to one year.
- Study 4 investigates the influence of acute complications on outcome 3 months after ischemic stroke, but it does not provide information on the duration of hospitalization for stroke complications after 3 months to one year.
Factors Associated with Hospital Readmission
- Study 2 found that patients at increased risk of readmission were older, had longer initial lengths of stay, and had modifiable comorbidities such as vascular risk factors, depression, epilepsy, and drug abuse.
- Social determinants associated with increased readmission included living in an urban setting, living in zip-codes with the lowest median income, and having Medicare insurance.
- Study 3 reports that in-hospital medical complications, such as pneumonia, urinary tract infection, and falls, were associated with longer length of stay and increased mortality among stroke unit patients.
Prevention and Treatment of Complications
- Study 5 discusses the use of antiplatelet therapy for secondary prevention of recurrent stroke in symptomatic patients with carotid atherosclerosis.
- Study 6 reviews the evidence for drugs and surgery in the prevention of ischemic stroke, including the use of warfarin, aspirin, and carotid endarterectomy.
- Study 4 highlights the need to improve prevention and treatment of complications in hospital to reduce mortality and poor outcome after stroke.