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Stroke-related length of hospitalization trends and in-hospital mortality in Peru

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dc.contributor.author Laban-Seminario, L. Max
dc.contributor.author Carrillo Larco, Rodrigo Martín
dc.contributor.author Bernabé Ortiz, Antonio
dc.date.accessioned 2023-01-06T13:40:11Z
dc.date.available 2023-01-06T13:40:11Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12989
dc.description.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. en_US
dc.language.iso eng
dc.publisher PeerJ
dc.relation.ispartofseries PeerJ
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject LOS en_US
dc.subject Stroke en_US
dc.subject Mortality en_US
dc.subject Survival en_US
dc.subject Peru en_US
dc.subject LATAM en_US
dc.title Stroke-related length of hospitalization trends and in-hospital mortality in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.7717/peerj.14467
dc.relation.issn 2167-8359


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