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Abstract

Background: Stroke remains a major global health burden, amounting to over 6.5 million deaths annually. Prolonged length of hospital stay due to stroke is associated with increased healthcare costs, increased rate of complications, and poor rehabilitation outcomes, especially in resource-constrained settings. Identification of factors contributing to extended hospitalizations can improve the resource allocation not only at the health systems level but also at the healthcare settings level and can patient care pathways and patient satisfaction.
Objectives: To determine the length of hospital stay among stroke patients and to identify demographic, clinical, and treatment-related predictors of prolonged hospital stay.
Study Design: A prospective observational study.
Duration and Place of Study. From 01 September 2024 to 28 February 2025 Department of Neurology, Shifa international Hospital Islamabad Methods: This prospective observational study was conducted over six months at Department of Neurology, Shifa international Hospital Islamabad. A total of 384 patients with confirmed ischemic or hemorrhagic stroke, admitted within 72 hours of symptom onset, were enrolled. Data on demographics, comorbidities, stroke characteristics, complications, and treatment interventions were collected. Stroke severity and functional status were assessed using NIHSS and Barthel Index at the time of admission, at 72 hours, and at follow-up was recorded. A multivariable linear regression model through the origin was used to identify predictors of hospital stay duration.
Results: The mean age of participants was 43.67 years, with 68.8% being male and 87.0% experiencing ischemic stroke. The average hospital stay was 11.44 days, with 52.9% experiencing prolonged hospitalization. The regression model revealed that marital status (B = 2.294, p < 0.001) and type of stroke (B = 2.157, p < 0.001) were the strongest predictors of increased hospital stay. Additional significant predictors included smoking history, antihypertensive use, and Barthel Index scores at admission. The final model explained 86.0% of the variance in hospital stay duration (R² = 0.860, Adjusted R² = 0.841, p < 0.001).
Conclusions: Prolonged hospital stay is common in stroke patients and is primarily influenced by baseline demographic and stroke-related characteristics, especially marital status and stroke type. These findings highlight the need for individualized discharge planning and early intervention strategies based on patient profiles to reduce hospital stay and optimize recovery.