Stroke-related length of hospitalization trends and in-hospital mortality in Peru
File(s)peerj-14467.pdf (3.27 MB)
Published version
Author(s)
Labán-Seminario, L Max
Carrillo-Larco, Rodrigo M
Bernabé-Ortiz, Antonio
Type
Journal Article
Abstract
BACKGROUND: Peru faces challenges to provide adequate care to stroke patients. Length of hospitalization and in-hospital mortality are two well-known indicators of stroke care. We aimed to describe the length of stay (LOS) of stroke in Peru, and to assess in-hospital mortality risk due to stroke, and subtypes. METHODS: This retrospective cohort study used hospitalization registries coding with ICD-10 from 2002 to 2017 (N = 98,605) provided by the Ministry of Health; in-hospital mortality was available for 2016-2017 (N = 6,566). Stroke cases aged ≥35 years were divided into subarachnoid hemorrhage (I60), intracerebral hemorrhage (I61), cerebral infarction (I63), and stroke not specified as hemorrhage or infarction (I64). Data included stroke LOS and in-hospital mortality; socio-demographic and clinical variables. We fitted a region- and hospital level-stratified Weibull proportional hazard model to assess the in-hospital mortality. RESULTS: The median LOS was 7 days (IQR: 4-13). Hemorrhagic strokes had median LOS longer than ischemic strokes and stroke not specified as hemorrhage or infarction (P = <0.001). The case fatality rate (CFR) of patients with stroke was 11.5% (95% CI [10-12%]). Subarachnoid hemorrhage (HR = 2.45; 95% CI [1.91-3.14]), intracerebral hemorrhage (HR = 1.95; 95% CI [1.55-2.46]), and stroke not specified as hemorrhage or infarction (HR = 1.45; 95% CI [1.16-1.81]) were associated with higher in-hospital mortality risk in comparison to ischemic strokes. DISCUSSION: Between 2002 and 2017, LOS due to stroke has not changed in Peru in stroke patients discharged alive. Hemorrhagic cases had the longest LOS and highest in-hospital mortality risk during 2016 and 2017. The findings of our study seem to be consistent with a previous study carried out in Peru and similar to that of HIC and LMIC, also there is an increased median LOS in stroke cases managed in specialized centers. Likewise, LOS seems to depend on the type of stroke, where ischemic stroke cases have the lowest LOS. Peru needs to improve access to stroke care.
Date Issued
2022-11-25
Date Acceptance
2022-11-04
Citation
PeerJ, 2022, 10
ISSN
2167-8359
Journal / Book Title
PeerJ
Volume
10
Copyright Statement
© 2022 Labán-Seminario et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/36452071
PII: 14467
Subjects
LATAM
LOS
Mortality
Peru
Stroke
Survival
Humans
Subarachnoid Hemorrhage
Retrospective Studies
Hospital Mortality
Peru
Stroke
Cerebral Hemorrhage
Hospitalization
Cerebral Infarction
Ischemic Stroke
Publication Status
Published
Coverage Spatial
United States
Article Number
ARTN e14467