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. 2022 Dec 12:11:1065.
doi: 10.4102/ajod.v11i0.1065. eCollection 2022.

Factors affecting length of hospital stay in stroke survivors in South Africa: A call for a stroke unit

Stephanie C Pillay  1 , Roxann Redant  2 , Nadia Umuneza  3 , Azra Hoosen  1 , Fiona Breytenbach  4 , Sameera Haffejee  3 , Zvifadzo Matsena-Zingoni  5 , Kganetso Sekome  6
Affiliations

Factors affecting length of hospital stay in stroke survivors in South Africa: A call for a stroke unit

Stephanie C Pillay et al. Afr J Disabil. .

Abstract

Background: 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: 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: 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: 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 (p < 0.001).

Conclusion: 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: The study highlights the urgency for re-evaluation of stroke care infrastructure within Gauteng to streamline and provide accessible stroke models of care.

Keywords: South Africa; length of stay; rehabilitation; stroke; stroke unit.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Flow diagram of included and excluded patient records.
FIGURE 2
FIGURE 2
Box and whisker plots for various length of hospital stay intervals evaluated for the stroke survivors.
See this image and copyright information in PMC

References

    1. Adeloye, D., 2014, ‘An estimate of the incidence and prevalence of stroke in africa: A systematic review and meta-analysis’, PLoS One 9(6), e0100724. 10.1371/journal.pone.0100724 - DOI - PMC - PubMed
    1. Agyemang, C., Attah-Adjepong, G., Owusu-Dabo, E., De-Graft Aikins, A., Addo, J., Edusei, A. et al. , 2012, ‘Stroke in Ashanti region of Ghana’, Ghana Medical Journal 46(2), 12–17. - PMC - PubMed
    1. Akinyemi, R.O., Ovbiagele, B., Adeniji, O.A., Sarfo, F.S.S., Abd-allah, F., Adoukonou, T. et al. , 2021, ‘Stroke in africa: Profile, progress, prospects and priorities’, Nature Reviews: Neurology 17(10), 634–656. 10.1038/s41582-021-00542-4 - DOI - PMC - PubMed
    1. Andrew, N.E., Middleton, S., Grimley, R., Anderson, C.S., Donnan, G.A., Lannin, N.A. et al. , 2019, ‘Hospital organizational context and delivery of evidence-based stroke care: A cross-sectional study’, Implementation Science 14, 6. 10.1186/s13012-018-0849-z - DOI - PMC - PubMed
    1. Banerjee, Y.P.M. & Paik, M.C., 2012, ‘Duration of diabetes and risk of ischeamic stroke. The Northern Manhattan study’, Stroke 43, 1212–1217. 10.1161/STROKEAHA.111.641381 - DOI - PMC - PubMed

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