Abstract WP386: Predictors of Length of Hospitalization in Patients Admitted With Intracerebral Hemorrhage in the United States
Background: We performed this study to determine the predictors of length of hospitalization in patients admitted with intracerebral hemorrhage using nationally representative data. Methods: We used the National Inpatient Sample (NIS) from 2010 to 2015 to assess the factors associated with length of stay in patients admitted with intracerebral hemorrhage using (ICD-9 CM diagnosis-related code 431). Patients who were transferred from another acute hospital or died within 2 days of admission were excluded. All variables pertaining to hospitalization were compared in 4 quartile groups on basis of length of hospital stay distribution (≤3, 4-6, 7-10 and ≥11 days) and median length of stay was calculated. The predictors of hospital stay exceeding the median length of stay were identified using multivariate logistic regression. Results: A total of 296,792patients were admitted with the diagnosis of intracerebral hemorrhage during the study period. The length of hospitalization was (≤3, 4-6, 7-10 and ≥11 days in 79,008 (26.5%), 89,019 (30.0%), 55,555 (18.7%) and 73,211 (24.6%) patients, respectively; median length of stay for the cohort was 6 days. In the multivariate logistic regression analysis, the following clinical factors were associated with length of hospitalization of ≥6 days (median): male (odds ratio [OR] 1.10), hypertension (OR 1.41 ), APRDRG severity (OR 2.87), history of alcohol use (OR 1.27 ), and in-hospital complications such as sepsis (OR 2.73), pneumonia (OR 2.30), urine tract infection (OR 2.34), pulmonary embolism (OR 1.42), and deep vein thrombosis (OR 5.06). Similarly in-hospital procedures such as craniotomy (OR 3.40), and transfusion (OR 2.09), were associated with length of hospitalization of ≥6 days. The excess hospitalization charges associated with length of hospitalization of ≥6 days was $107,915. Conclusion: Prolonged hospitalization is associated with significantly higher cost of hospitalization. The most important determinants being pre-existing medical comorbidities and potentially preventable in-hospital complications.