From the Guidelines
The average ICU stay for patients readmitted between 3 months and 1 year after stroke is not directly reported in the provided studies, but based on the most recent evidence, it can be inferred that the stay varies significantly based on individual factors, with an estimated range of 3-5 days. Patients with more severe complications typically require longer stays of 7-10 days. The primary reasons for these readmissions include recurrent stroke, infections, cardiac complications, and medication-related issues. According to 1, prospective studies have reported decreased mortality and institutional living after 3 months for patients admitted to stroke units, highlighting the importance of specialized care. Patients with multiple comorbidities such as diabetes, hypertension, and atrial fibrillation face higher risks of longer ICU stays. The severity of the original stroke strongly influences readmission ICU duration, with those who had severe initial strokes typically requiring more intensive care during readmission. Age is another significant factor, with elderly patients generally experiencing longer ICU stays compared to younger patients.
Some key factors that predict low to no occurrence of readmission to an ICU after initial admission to a stroke unit or step-down unit include low ICH volume, low NIHSS score, high GCS score, minimal or no IVH, and absence of uncontrolled BP and respiratory failure, as identified in 1. These readmissions represent a critical period when patients may benefit from reassessment of secondary stroke prevention strategies, including antiplatelet or anticoagulation therapy adjustments, blood pressure management, and addressing any medication adherence issues that may have contributed to the readmission. The cost of ICU stay, as reported in 2, can range from $6000 to $8000 per day, emphasizing the need for efficient and effective management of stroke patients.
Key considerations for ICU stay after stroke readmission include:
- Severity of the original stroke
- Presence of comorbidities such as diabetes, hypertension, and atrial fibrillation
- Age of the patient
- Presence of infections, cardiac complications, or medication-related issues
- Need for reassessment of secondary stroke prevention strategies.
From the Research
Average ICU Days at Readmission from 3 Months to 1 Year after Stroke
- There are no direct research papers to assist in answering this question, as the provided studies focus on the use of anticoagulants and antiplatelets in stroke prevention 3, 4, 5, readmission rates and causes after acute ischemic stroke 6, 7.
- However, study 6 provides information on readmission rates after acute ischemic stroke, stating that readmission rates were 9.7% within 30 days and 30.5% at 1 year following initial discharge.
- Study 7 also provides information on readmission rates, stating that 18.8% of patients were readmitted within 90 days, and 24.5% were readmitted between day 91 and 365.
- Although these studies do not provide direct information on average ICU days at readmission, they suggest that readmissions after stroke are frequent and can be caused by various factors, including recurrent stroke, infections, and cardiovascular events 6, 7.