Relationship of initial hematocrit level to discharge destination and resource utilization after ischemic stroke: a pilot study.
OBJECTIVE
To examine the association between initial hematocrit level at the time of ischemic stroke, discharge destination, and resource utilization.


METHODS
Case series.


METHODS
University hospital.


METHODS
A total of 1012 consecutive patients with ischemic stroke admitted to a university health system between August 3, 1995, and June 24, 1999.


METHODS
Not applicable.


METHODS
Length of stay, hospital cost, and discharge disposition.


RESULTS
Of 1012 patients presenting with ischemic stroke, 58% were discharged home, 10% were discharged home with home care services, 15% were discharged to a rehabilitation hospital, 11% were discharged to a skilled or intermediate care facility, and 6% died. After adjusting for age, sex, race, and comorbidities, a significant association (P=.009) existed between discharge outcome and initial hematocrit level. The probability of achieving an equivalent or less favorable outcome increased at both high and low hematocrit levels, with a minimum probability at a hematocrit level of approximately 45%.


CONCLUSIONS
An association exists between hematocrit level at the time of ischemic stroke and discharge outcome. Midrange hematocrit levels appear to be associated with discharge to home rather than to an inpatient rehabilitation unit or to a nursing facility. Further study is indicated to examine the relationship among hematocrit level, stroke severity, and outcome.
Diamond
Paul T
PT
Department of Physical Medicine and Rehabilitation and Health Evaluation Sciences, University of Virginia Health System Charlatosville, VA 22908-1004, USA. ptd2m@Virginia.edu
Gale
Shawn D
SD
Evans
Brent A
BA
D000368:Aged; D001809:Blood Viscosity; D002545:Brain Ischemia / Q000150:complications*; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006295:Health Resources / Q000706:statistics & numerical data*; D006400:Hematocrit; D017721:Hospital Costs / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000209:etiology / Q000401:mortality; D000071939:Stroke Rehabilitation; D014768:Virginia / Q000453:epidemiology