Causes of unjustified hospital stay following cerebral infarction

The frequency and causes of prolonged length of stay (LOS) in patients with acute ischemic stroke were studied in 20 patients admitted to a university hospital participating in the International Stroke Trial (IST). The protocol for prolonged LOS study designed by R. S. Goldman et al. (1996) was reproduced. Mean (+/- SD) LOS was 13.1 +/- 11.5 days (median = 10 days). Prolonged LOS occurred in 12 (60%) patients. In these 12 patients, a total of 83 (62%) of 134 days were found to be unnecessary (6.9 +/- 4.6). Most of these patients remained hospitalized while awaiting for routinely performed tests, such as 2D echocardiogram or carotid Doppler. LOS was not influenced by patient characteristics (age or gender) or specific location in the hospital (emergency room or other). In conclusion, LOS and hospitalization costs can be markedly reduced in this hospital by rational use of already available diagnostic tests.