Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in China

Abstract Background Research on factors influencing prolonged length of stay (LOS) and its impact on prognosis in intracerebral hemorrhage (ICH) patients is limited. This study aimed to identify clinical predictors associated with prolonged LOS and to explore the potential impact of prolonged LOS on...

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Main Authors: Zhuangzhuang Zhang, Jieyu Li, Wenzhe Wang, Haowei Wang, Junlong Shu, Haiqiang Jin, Peng Sun, Craig S. Anderson, Zhaoxia Wang, Yining Huang, Weiping Sun, for the ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) Investigators
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Language:English
Published: BMC 2025-07-01
Series:BMC Medicine
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Online Access:https://doi.org/10.1186/s12916-025-04241-5
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author Zhuangzhuang Zhang
Jieyu Li
Wenzhe Wang
Haowei Wang
Junlong Shu
Haiqiang Jin
Peng Sun
Craig S. Anderson
Zhaoxia Wang
Yining Huang
Weiping Sun
for the ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) Investigators
author_facet Zhuangzhuang Zhang
Jieyu Li
Wenzhe Wang
Haowei Wang
Junlong Shu
Haiqiang Jin
Peng Sun
Craig S. Anderson
Zhaoxia Wang
Yining Huang
Weiping Sun
for the ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) Investigators
author_sort Zhuangzhuang Zhang
collection DOAJ
description Abstract Background Research on factors influencing prolonged length of stay (LOS) and its impact on prognosis in intracerebral hemorrhage (ICH) patients is limited. This study aimed to identify clinical predictors associated with prolonged LOS and to explore the potential impact of prolonged LOS on the prognosis of patients with mild to moderate ICH. Methods The study included mild to moderate ICH patients from the China Quality Evaluation of Stroke Care and Treatment (QUEST) database. Prolonged LOS was defined as a hospitalization exceeding 14 days. Sociodemographic characteristics, medical histories, stroke severity, in-hospital treatments, complications, discharge destination, and hospital characteristics were compared between the prolonged and normal LOS groups to screen for the potential predictors of extending LOS after ICH. The outcomes were the proportions of poor outcome at 3 months and 12 months after stroke onset. Poor outcome was defined as an mRS score of 3–5 or death. Results A total of 1055 mild to moderate ICH patients were enrolled in the study, with 281 (26.6%) exhibiting a LOS of 14 days or less, and 774 (73.4%) exceeding 14 days. The multivariable logistic regression analysis identified several independent predictors of prolonged LOS including younger age, higher annual household income, possession of medical insurance, a history of antithrombotic medication use, infection complication during hospitalization, and hospital regions. Unadjusted analyses showed there were no significant differences in the risk of poor outcome between the prolonged and normal LOS groups at 3 and 12 months after ICH (OR 0.89, 95% CI 0.67–1.17, P = 0.404; OR 0.82, 95% CI 0.61–1.09, P = 0.165). The adjusted models and the sensitivity analysis using propensity score matching and subgroup analysis produced the similar results. Conclusions Various factors contributed to prolonged LOS in mild to moderate ICH patients, including younger age, higher annual household income, possession of medical insurance, a history of antithrombotic medication use, the occurrence of infections during hospitalization, and the hospital regions. A prolonged LOS exceeding 14 days was not associated with a better functional outcome for mild to moderate ICH patients at 3 and 12 months.
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spelling doaj-art-a2bb900631ce4b3f8d1e7d7714213e602025-08-20T03:43:22ZengBMCBMC Medicine1741-70152025-07-0123111210.1186/s12916-025-04241-5Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in ChinaZhuangzhuang Zhang0Jieyu Li1Wenzhe Wang2Haowei Wang3Junlong Shu4Haiqiang Jin5Peng Sun6Craig S. Anderson7Zhaoxia Wang8Yining Huang9Weiping Sun10for the ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) InvestigatorsDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalThe George Institute for Global Health, Royal Prince Alfred Hospital and the University of New South WalesDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalAbstract Background Research on factors influencing prolonged length of stay (LOS) and its impact on prognosis in intracerebral hemorrhage (ICH) patients is limited. This study aimed to identify clinical predictors associated with prolonged LOS and to explore the potential impact of prolonged LOS on the prognosis of patients with mild to moderate ICH. Methods The study included mild to moderate ICH patients from the China Quality Evaluation of Stroke Care and Treatment (QUEST) database. Prolonged LOS was defined as a hospitalization exceeding 14 days. Sociodemographic characteristics, medical histories, stroke severity, in-hospital treatments, complications, discharge destination, and hospital characteristics were compared between the prolonged and normal LOS groups to screen for the potential predictors of extending LOS after ICH. The outcomes were the proportions of poor outcome at 3 months and 12 months after stroke onset. Poor outcome was defined as an mRS score of 3–5 or death. Results A total of 1055 mild to moderate ICH patients were enrolled in the study, with 281 (26.6%) exhibiting a LOS of 14 days or less, and 774 (73.4%) exceeding 14 days. The multivariable logistic regression analysis identified several independent predictors of prolonged LOS including younger age, higher annual household income, possession of medical insurance, a history of antithrombotic medication use, infection complication during hospitalization, and hospital regions. Unadjusted analyses showed there were no significant differences in the risk of poor outcome between the prolonged and normal LOS groups at 3 and 12 months after ICH (OR 0.89, 95% CI 0.67–1.17, P = 0.404; OR 0.82, 95% CI 0.61–1.09, P = 0.165). The adjusted models and the sensitivity analysis using propensity score matching and subgroup analysis produced the similar results. Conclusions Various factors contributed to prolonged LOS in mild to moderate ICH patients, including younger age, higher annual household income, possession of medical insurance, a history of antithrombotic medication use, the occurrence of infections during hospitalization, and the hospital regions. A prolonged LOS exceeding 14 days was not associated with a better functional outcome for mild to moderate ICH patients at 3 and 12 months.https://doi.org/10.1186/s12916-025-04241-5Length of stayIntracerebral hemorrhageOutcomePredictors
spellingShingle Zhuangzhuang Zhang
Jieyu Li
Wenzhe Wang
Haowei Wang
Junlong Shu
Haiqiang Jin
Peng Sun
Craig S. Anderson
Zhaoxia Wang
Yining Huang
Weiping Sun
for the ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) Investigators
Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in China
BMC Medicine
Length of stay
Intracerebral hemorrhage
Outcome
Predictors
title Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in China
title_full Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in China
title_fullStr Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in China
title_full_unstemmed Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in China
title_short Predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage: a multicenter prospective cohort study in China
title_sort predictors and outcomes associated with prolonged hospital length of stay in intracerebral hemorrhage a multicenter prospective cohort study in china
topic Length of stay
Intracerebral hemorrhage
Outcome
Predictors
url https://doi.org/10.1186/s12916-025-04241-5
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