Prediction of hospitalization duration for acute stroke in Belgium

Abstract

We aim to predict the duration of hospitalization for acute stroke in Belgium by evaluating the external validity of the prolonged length of stay (PLOS) score and by formulating a new prediction score that may be better suited for the Belgian healthcare system. This single-center retrospective study is based on data collected prospectively from the departmental stroke registry. To validate the PLOS score, receiver operating characteristic curves were constructed and Hosmer-Lemeshow tests were implemented. Odds ratios were calculated by models of logistic regression, based on predictors of length of stay (LOS) with significance in univariate analyses, and were translated into a new risk score. C-statistics for prediction of LOS ≥7 days, LOS ≥14 days, and LOS ≥30 days using the PLOS score were in the range of 0.6-0.7. Thrombolytic therapy, mortality, and need for institutionalization had a notable negative influence on the discrimination of the PLOS score. Overall, the PLOS score performed better for prediction of LOS ≥14 days than for LOS ≥7 days and ≥30 days. The Belgian length of stay for stroke (BLOSS) score is proposed as a simplified prediction model based only on the NIHSS score and age. The PLOS score showed moderate value for prediction of hospitalization duration for acute stroke in this Belgian cohort. A prediction model based only on age and stroke severity may be a worthy alternative.