title: Exploring the impact of intravenous thrombolysis on length of stay for acute ischemic stroke: a retrospective cohort study.
abstract: BACKGROUND
  Understanding the factors that influence the hospital length of stay (LOS) for patients with stroke will help in discharge planning and stroke unit management. We explored how intravenous thrombolysis (IVT) affects LOS in an acute-care hospital setting.
  
  
  METHODS
  We analyzed adult patients with ischemic stroke who presented within 48 h of onset from a hospital-based stroke registry. The relationship between IVT and prolonged LOS (LOS ≥ 7 days) was studied by both multivariate logistic regression and the classification and regression tree (CART) analyses.
  
  
  RESULTS
  Among the study population of 3054 patients, 1110 presented within 4.5 h. The median LOS (interquartile range) was 7 (4 to 11) days, and 1619 patients had prolonged LOS. Multivariate logistic regression revealed that IVT (odds ratio, 0.53; 95 % confidence interval 0.38-0.74) was an independent factor that reduced the risk of prolonged LOS, whereas age, National Institutes of Health Stroke Scale (NIHSS) score, diabetes mellitus, and leukocytosis at admission predicted prolonged LOS. CART analysis identified 4 variables (NIHSS score, IVT, leukocytosis at admission, and age) as important factors to partition the patients into six subgroups. The patient subgroup that had an NIHSS score of 5 to 7 and received IVT had the lowest probability (19 %) of prolonged LOS.
  
  
  CONCLUSIONS
  IVT reduced the risk of prolonged LOS in patients with acute ischemic stroke. Measures to increase the rate of IVT are encouraged.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Zhongxiao Rd, Chiayi City, 60002, Taiwan. valjean118@gmail.com.
authors.forename: Ling-Chien
authors.initials: LC
authors.lastname: Hung
authors.affiliation: Department of Information Management and Institute of Healthcare Information Management, National Chung Cheng University, Chiayi County, Taiwan. yahan.hu@mis.ccu.edu.tw.
authors.forename: Ya-Han
authors.initials: YH
authors.lastname: Hu
authors.affiliation: Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Zhongxiao Rd, Chiayi City, 60002, Taiwan. richard.sfsung@gmail.com.|Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan, Taiwan. richard.sfsung@gmail.com.
authors.forename: Sheng-Feng
authors.initials: SF
authors.lastname: Sung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D007511:Ischemia; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014481:United States