Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage

1. Prolonged hospital stay in mild to moderate intracerebral hemorrhage (ICH) was predicted by younger age, higher income, medical insurance, prior antithrombotic use, in-hospital infections, and geographic region.

2. Extended hospitalization may not be necessary for improved recovery in mild to moderate ICH.

Evidence Rating Level: 2 (Good)

In this multicenter prospective cohort study, Zhang et al. investigated the predictors of prolonged hospital length of stay (LOS) and its relationship with functional outcomes in patients with mild to moderate intracerebral hemorrhage (ICH) in China. Using data from the ChinaQUEST registry, 1,055 ICH patients were included after excluding those with severe disease, in-hospital mortality, or outlier LOS. Prolonged LOS was defined as hospitalization longer than 14 days. Multivariable logistic regression identified several predictors of prolonged LOS, including younger age, higher household income, possession of medical insurance, history of antithrombotic drug use, in-hospital infections, and hospital region. The median LOS was 20 days, and 73.4% of patients exceeded the 14-day threshold. However, both unadjusted and adjusted analyses, as well as sensitivity analyses using propensity score matching, demonstrated that prolonged LOS was not associated with better outcomes at 3 or 12 months, defined as a modified Rankin Scale score of 3–5 or death. These findings suggest that while socioeconomic and clinical factors influence LOS, extending hospitalization beyond 14 days does not improve long-term functional outcomes in this patient population. The results emphasize the need for optimized discharge planning and efficient resource utilization without compromising patient care.

Click to read the study in BMC Medicine

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