Factors affecting length of hospital stay in stroke survivors in South Africa: A call for a stroke unit.
South Africa
length of stay
rehabilitation
stroke
stroke unit
Journal
African journal of disability
ISSN: 2223-9170
Titre abrégé: Afr J Disabil
Pays: South Africa
ID NLM: 101623460
Informations de publication
Date de publication:
2022
2022
Historique:
received:
02
05
2022
accepted:
04
09
2022
entrez:
26
12
2022
pubmed:
27
12
2022
medline:
27
12
2022
Statut:
epublish
Résumé
Stroke in Africa is a growing and neglected crisis with the incidence more than doubling in low- to middle-income countries in the last four decades. Despite this growing threat, implementation of stroke models of care in hospitals is lacking. Stroke units as a model of care have been shown to decrease mortality, reduce length of hospital stay (LOS) and improve outcomes in stroke survivors. To determine the profile of stroke survivors and identify factors contributing to LOS at Chris Hani Baragwanath Academic Hospital (CHBAH) in South Africa to support stroke unit implementation. This study involved a retrospective record review of stroke survivors admitted to CHBAH between September 2018 and May 2019. Factors associated with LOS were determined using linear regression models; univariate and multiple regression models were fitted. A total of 567 participants' data were included. Overall, 51.85% of the participants required services from all rehabilitation disciplines. The median LOS was 9 days (interquartile ranges [IQR]: 5-11 days) with each discipline providing an average of six sessions. Participants who were referred to the rehabilitation team 3 days after admission to hospital stayed 6 days longer compared with those participants who were referred earlier ( Delayed referral to the rehabilitation team resulted in increased LOS. This study supports the need for dedicated stroke units to decrease hospital LOS and improve patients' outcomes by ensuring early, well-coordinated rehabilitation intervention and discharge planning. The study highlights the urgency for re-evaluation of stroke care infrastructure within Gauteng to streamline and provide accessible stroke models of care.
Sections du résumé
Background
UNASSIGNED
Stroke in Africa is a growing and neglected crisis with the incidence more than doubling in low- to middle-income countries in the last four decades. Despite this growing threat, implementation of stroke models of care in hospitals is lacking. Stroke units as a model of care have been shown to decrease mortality, reduce length of hospital stay (LOS) and improve outcomes in stroke survivors.
Objectives
UNASSIGNED
To determine the profile of stroke survivors and identify factors contributing to LOS at Chris Hani Baragwanath Academic Hospital (CHBAH) in South Africa to support stroke unit implementation.
Method
UNASSIGNED
This study involved a retrospective record review of stroke survivors admitted to CHBAH between September 2018 and May 2019. Factors associated with LOS were determined using linear regression models; univariate and multiple regression models were fitted.
Results
UNASSIGNED
A total of 567 participants' data were included. Overall, 51.85% of the participants required services from all rehabilitation disciplines. The median LOS was 9 days (interquartile ranges [IQR]: 5-11 days) with each discipline providing an average of six sessions. Participants who were referred to the rehabilitation team 3 days after admission to hospital stayed 6 days longer compared with those participants who were referred earlier (
Conclusion
UNASSIGNED
Delayed referral to the rehabilitation team resulted in increased LOS. This study supports the need for dedicated stroke units to decrease hospital LOS and improve patients' outcomes by ensuring early, well-coordinated rehabilitation intervention and discharge planning.
Contribution
UNASSIGNED
The study highlights the urgency for re-evaluation of stroke care infrastructure within Gauteng to streamline and provide accessible stroke models of care.
Identifiants
pubmed: 36567925
doi: 10.4102/ajod.v11i0.1065
pii: AJOD-11-1065
pmc: PMC9772707
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1065Informations de copyright
© 2022. The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Références
BMC Health Serv Res. 2019 Nov 4;19(1):789
pubmed: 31684935
S Afr Med J. 2012 Aug 22;102(9):765-7
pubmed: 22958702
Health Econ. 2012 Aug;21 Suppl 2:129-40
pubmed: 22815118
Front Neurol. 2019 Mar 08;10:200
pubmed: 30930832
Cochrane Database Syst Rev. 2020 Apr 23;4:CD000197
pubmed: 32324916
Age Ageing. 2002 Sep;31(5):365-71
pubmed: 12242199
PLoS One. 2014 Jun 26;9(6):e100724
pubmed: 24967899
Stroke. 2012 May;43(5):1212-7
pubmed: 22382158
Interv Neuroradiol. 2019 Feb;25(1):31-37
pubmed: 30352535
Cardiovasc J Afr. 2015 Mar-Apr;26(2 Suppl 1):S27-38
pubmed: 25962945
S Afr Fam Pract (2004). 2020 Aug 20;62(1):e1-e4
pubmed: 32896140
S Afr Med J. 2010 Nov 10;100(11 Pt 2):747-78
pubmed: 21081029
Nat Rev Neurol. 2021 Oct;17(10):634-656
pubmed: 34526674
BMC Womens Health. 2021 Apr 17;21(1):160
pubmed: 33865368
Lancet Glob Health. 2016 Sep;4(9):e642-53
pubmed: 27539806
Ghana Med J. 2012 Jun;46(2 Suppl):12-7
pubmed: 23661812
Nat Rev Dis Primers. 2019 Oct 10;5(1):70
pubmed: 31601801
BMC Neurol. 2015 Apr 12;15:54
pubmed: 25880843
Circ Res. 2017 Feb 3;120(3):472-495
pubmed: 28154098
Pan Afr Med J. 2017 Apr 25;26:228
pubmed: 28690742
Health Res Policy Syst. 2019 Jun 6;17(1):56
pubmed: 31170992
Lancet Neurol. 2008 Oct;7(10):915-26
pubmed: 18722812
Implement Sci. 2019 Jan 18;14(1):6
pubmed: 30658654
Stroke. 2009 Jan;40(1):18-23
pubmed: 19008467
Vasc Med. 2017 Apr;22(2):135-145
pubmed: 27815349
Lancet Glob Health. 2019 Oct;7(10):e1375-e1387
pubmed: 31537368
S Afr J Commun Disord. 2020 Nov 26;67(1):e1-e8
pubmed: 33314954
Bull World Health Organ. 2016 Sep 1;94(9):634-634A
pubmed: 27708464
Lancet Neurol. 2012 Oct;11(10):878-90
pubmed: 22995692