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Fast-Track versus Long-Term Hospitalizations for Patients with Non-Disabling Acute Ischemic Stroke

Fladt, Joachim and Hofmann, Laurine and Coslovsky, Michael and Imhof, Anna and Seiffge, David J. and Polymeris, Alexandros and Thilemann, Sebastian and Traenka, Christopher and Sutter, Raoul Christian and Schaer, Beat and Kaufmann, Beat A. and Peters, Nils and Bonati, Leo H. and Engelter, Stefan T. and Lyrer, Philippe A. and De Marchis, Gian Marco. (2019) Fast-Track versus Long-Term Hospitalizations for Patients with Non-Disabling Acute Ischemic Stroke. European journal of neurology, 26. pp. 51-57.

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Official URL: https://edoc.unibas.ch/65037/

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Abstract

We aimed to assess the feasibility and safety of fast-track hospitalizations in a selected cohort of patients with stroke.; We included patients hospitalized at the Stroke Center of the University Hospital Basel, Switzerland, with an acute ischemic stroke (AIS) confirmed on MR-DWI. Neurological deficits of the included patients were non-disabling, i.e. not interfering with activities of daily living and compatible with a direct discharge home. We excluded patients with premorbid disability. All patients were admitted to the Stroke Center for ≥24 hours. We compared two study groups - fast-track hospitalizations (≤72 hours) and long-term hospitalizations (>72 hours). The primary endpoint was a composite of any unplanned re-hospitalization for any reason within 3 months since hospital discharge, and a mRS 3-6 at 3 months. Adjustment for confounders was done using inverse probability of treatment weights (IPTW).; Among the 521 patients who met the inclusion criteria, fast-track hospitalizations were performed in 79 patients (15%). In the fast-track group, 7 patients (8.9%) met the primary endpoint, compared to 37 (8.4%) in the long-term group (OR 1.06, 95%-CI: 0.42-2.34, P=0.88). After weighting for IPTW, the odds of the primary endpoint remained similar between both arms (OR; IPTW; 1.27, 95%-CI: 0.51-3.16, P=0.61). The costs of a fast-track hospitalization were lower, on average, by 4'994 USD.; Fast-track hospitalizations including a full work-up proved to be feasible, showed no increased risk, and were less expensive compared to long-term hospitalizations. This article is protected by copyright. All rights reserved.
Faculties and Departments:03 Faculty of Medicine
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Neurologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Neurologie
UniBasel Contributors:Sutter, Raoul Christian
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Wiley
ISSN:1351-5101
e-ISSN:1468-1331
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:12 Aug 2020 14:39
Deposited On:12 Aug 2020 14:39

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