关键词:

脑出血, 住院时间, 住院费用, 影响因素

Abstract:

Objective　To investigate the influencing factors of prolonged length of hospital stay (LOS) in patients with acute intracerebral hemorrhage (ICH). Methods　This retrospective study included 310 patients with ICH in three branches of Guangdong Hospital of Traditional Chinese Medicine from May 2019 to May 2021. We recorded baseline data and laboratory data within 24 hours after admission. According to the LOS, the patients were divided into a prolonged group (>14 days) and a non-prolonged group (≤14 days). Among the 211 cases in the non-prolonged group, there were 142 males, aged (61.62±15.51) years. Among the 99 patients in the prolonged group, there were 64 males, aged (63.39±15.12) years. Independent sample t test, Mann-Whitney U test, χ² test, and multivariate logistic regression analysis were used to analyze the independent influencing factors of prolonged LOS in ICH patients. Results　Among the 310 ICH patients enrolled, the average LOS was 12 days. The hospitalization cost in the prolonged group was higher than that in the non-prolonged group [22 613.48 (15 343.92, 38 598.77) yuan vs. 98 618.66 (60 511.49, 152 027.37) yuan, Z=-11.194, P<0.001], accounting for 63.1% of the total hospitalization medical cost. Multivariate logistic regression analysis showed that surgery (OR=2.477, 95%CI 1.286-4.770), stroke-associated pneumonia (SAP) (OR=2.189, 95%CI 1.033-4.641), in-hospital death (OR=0.073, 95%CI 0.021-0.249), and discharge from hospital with non-severe disability [modified Rankin scale (mRS) score ≤2 points] (OR=0.244, 95%CI 0.110-0.539) were independent influencing factors for prolonged LOS in ICH patients (all P<0.05). Conclusions　Surgery, in-hospital death, SAP, and discharge from hospital with non-severe disability are closely related to prolonged LOS in patients with ICH. To achieve the purpose of reducing invalid LOS, reducing the waste of medical resources, and reducing the burden on patients and society, we suggest optimizing the surgical procedure, preventing and treating SAP at an early stage, and using antibacterial drugs rationally. In addition, we should pay attention to early rehabilitation management and establish a stable two-way referral channel with rehabilitation hospitals.

Key words:

Intracerebral hemorrhage, Length of hospital stay, Hospitalization costs, Influencing factors