title: Prediction of hospitalization duration for acute stroke in Belgium.
abstract: We aim to predict the duration of hospitalization for acute stroke in Belgium by evaluating the external validity of the prolonged length of stay (PLOS) score and by formulating a new prediction score that may be better suited for the Belgian healthcare system. This single-center retrospective study is based on data collected prospectively from the departmental stroke registry. To validate the PLOS score, receiver operating characteristic curves were constructed and Hosmer-Lemeshow tests were implemented. Odds ratios were calculated by models of logistic regression, based on predictors of length of stay (LOS) with significance in univariate analyses, and were translated into a new risk score. C-statistics for prediction of LOS ≥7 days, LOS ≥14 days, and LOS ≥30 days using the PLOS score were in the range of 0.6-0.7. Thrombolytic therapy, mortality, and need for institutionalization had a notable negative influence on the discrimination of the PLOS score. Overall, the PLOS score performed better for prediction of LOS ≥14 days than for LOS ≥7 days and ≥30 days. The Belgian length of stay for stroke (BLOSS) score is proposed as a simplified prediction model based only on the NIHSS score and age. The PLOS score showed moderate value for prediction of hospitalization duration for acute stroke in this Belgian cohort. A prediction model based only on age and stroke severity may be a worthy alternative.
authors.affiliation: Department of Internal Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Beckers
authors.forename: Ann
authors.initials: A
authors.lastname: De Smedt
authors.forename: Robbert-Jan
authors.initials: RJ
authors.lastname: Van Hooff
authors.forename: Sylvie
authors.initials: S
authors.lastname: De Raedt
authors.forename: Rita
authors.initials: R
authors.lastname: Van Dyck
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.forename: Jacques
authors.initials: J
authors.lastname: De Keyser
authors.forename: Raf
authors.initials: R
authors.lastname: Brouns
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000453:epidemiology* / Q000628:therapy*; D013997:Time Factors