Destination Home? Patterns and Predictors of Home Discharge in Acute Stroke Survivors

Abstract

Introduction: Stroke is a leading cause of permanent disability, often requiring participation in a specialized and personalized rehabilitation program following the event. Around 30% of stroke survivors experience ongoing disabilities that require extensive support from families and healthcare providers. However, there is a gap in national literature on discharge planning and care coordination for these patients, as well as predictive factors for their ability to return home after a stroke. The primary aim of this study was to describe the hospital discharge outcome of patients admitted with acute stroke. Secondary objectives included a descriptive analysis of their demographic profile, risk factors, acute phase treatment, and length of hospitalization, as well as identification of predictors of destination at discharge.
Methods: A retrospective cohort study of patients admitted with acute stroke during 2021 was performed, including a descriptive analysis of the demographic and clinical characteristics, and post-hospital discharge destination. Non-parametric tests were used for association analysis, and linear regression was used to identify predictors of home discharge.
Results: Two hundred and four patients were included. The majority were discharged home with or without outpatient rehabilitation (55.4%). Significant predictors of destination of discharge included age, previous history of stroke, nasogastric tube feeding need on admission, vesico-sphincteric abnormalities on admission, National Institutes of Health Stroke scores (NIHSS) ≤10 on admission and after acute treatment, and ≤ 7 days stays on the stroke unit. Sex, the type of stroke, Trial of Org 10172 in Acute Stroke Treatment classification (TOAST) or Oxfordshire Community Stroke Project (OCSP) classifications did not appear to have a discernible association with discharge destination.
Conclusion: These results help to understand the factors that influence discharge home after stroke, as well as the ability to predict discharge home. This is critical information for optimizing the rehabilitation of stroke survivors, reducing the length of hospital stays and associated costs.