Defining Prolonged Length of Acute Care Stay for Surgically and Conservatively Treated Patients with Spontaneous Intracerebral Hemorrhage: A Population-Based Analysis.
BACKGROUND
The definition of prolonged length of stay (LOS) during acute care remains unclear among surgically and conservatively treated patients with intracerebral hemorrhage (ICH).


METHODS
Using a population-based quality assessment registry, we calculated change points in LOS for surgically and conservatively treated patients with ICH. The influence of comorbidities, baseline characteristics at admission, and in-hospital complications on prolonged LOS was evaluated in a multivariate model.


RESULTS
Overall, 13272 patients with ICH were included in the analysis. Surgical therapy of the hematoma was documented in 1405 (10.6%) patients. Change points for LOS were 22 days (CI: 8, 22; CL 98%) for surgically treated patients and 16 days (CI: 16, 16; CL: 99%) for conservatively treated patients. Ventilation therapy was related to prolonged LOS in surgically (OR: 2.2, 95% CI: 1.5-3.1; P < 0.001) and conservatively treated patients (OR: 2.5, 95% CI: 2.2-2.9; P < 0.001). Two or more in-hospital complications in surgical patients (OR: 2.7, 95% CI: 2.1-3.5) and ≥1 in conservative patients (OR: 3.0, 95% CI: 2.7-3.3) were predictors of prolonged LOS.


CONCLUSIONS
The definition of prolonged LOS after ICH could be useful for several aspects of quality management and research. Preventing in-hospital complications could decrease the number of patients with prolonged LOS.
Department of Neurosurgery, Justus-Liebig University Giessen, Klinikstrasse 33, 35392 Giessen, Germany.
Marco
M
Stein
Institute of Quality Assurance Hesse, Frankfurter Strasse 10-14, 65760 Eschborn, Germany.
Björn
B
Misselwitz
Department of Neurology and Neurological Rehabilitation, Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Strasse 2, 89312 Günzburg, Germany.
Gerhard F
GF
Hamann
Department of Neurosurgery, Justus-Liebig University Giessen, Klinikstrasse 33, 35392 Giessen, Germany.
Malgorzata A
MA
Kolodziej
Department of Neurosurgery, Justus-Liebig University Giessen, Klinikstrasse 33, 35392 Giessen, Germany.
Marcus H T
MH
Reinges
Department of Neurosurgery, Justus-Liebig University Giessen, Klinikstrasse 33, 35392 Giessen, Germany.
Eberhard
E
Uhl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D003710:Demography; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012307:Risk Factors