From the Guidelines
The average length of ICU stay for patients readmitted between 3 months and 1 year after stroke is typically 1-2 days, as most patients who meet certain criteria such as low ICH volume, low NIHSS score, high GCS score, minimal or no IVH, and absence of uncontrolled BP and respiratory failure are less likely to require prolonged ICU care 1.
Factors Influencing ICU Stay
The length of ICU stay is influenced by several factors including stroke severity, comorbidities (particularly diabetes, hypertension, and atrial fibrillation), age, and the specific complication requiring readmission.
- Respiratory complications often necessitate longer ICU care due to ventilation requirements.
- Patients with more severe complications or those experiencing recurrent strokes may require longer stays.
Reducing ICU Readmission Risk
To reduce ICU readmission risk, patients should:
- Strictly adhere to prescribed medications such as antiplatelet agents (aspirin 81-325mg daily, clopidogrel 75mg daily) or anticoagulants (warfarin with target INR 2-3, direct oral anticoagulants).
- Maintain blood pressure control (typically below 140/90 mmHg).
- Attend all follow-up appointments.
- Immediately report warning signs like sudden weakness, speech difficulties, or severe headaches.
Cost Considerations
The cost of ICU care is significant, with approximate costs ranging from $6000 to $8000 per day in a major teaching hospital 1.
- The cost of thrombolytic and adjunctive drugs or thrombolytic devices may also contribute to hospital costs.
- Therefore, reducing ICU readmission risk and length of stay is crucial to minimize healthcare costs and improve patient outcomes.
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 2, 3, 4, readmission rates and causes after acute ischemic stroke 5, 6.
- However, study 5 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 6 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 5, 6.