Gender and Family Composition Related to Discharge Destination and Length of Hospital Stay after Acute Stroke

Gender and Family Composition Related to Discharge Destination and Length of Hospital Stay after Acute Stroke

KAZUHIRO OHWAKI, HIDEKI HASHIMOTO, MIKIYA SATO, HAJIME TOKUDA¹ and EIJI YANO

Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan, and ¹Tokuda Neurosurgical Hospital, Kagoshima, Japan

Informal care by family members still plays an important role in home care after acute stroke. This study determined the clinical and demographic factors, such as family structure, that predict discharge to home and length of hospital stay (LOS) after acute stroke hospitalization. We reviewed the sex, age, family structure before stroke, type of stroke, size of the lesion, activities of daily living (ADL) function at discharge, discharge destination, and LOS of stroke patients (114 cerebral infarctions and 44 intracerebral hemorrhages) admitted to a neurosurgical hospital. Patients with cerebral infarction were older than those with intracerebral hemorrhage (median 75 vs 66 years). Ninety-eight were discharged to home (62%). In the logistic regression analysis, low ADL function, medium or large infarction, and intracerebral hemorrhage (vs lacunar infarction) were significantly associated with discharge to a destination other than home. Of the patients discharged home, low ADL function was strongly associated with LOS in the multiple regression analysis. In addition, living with a spouse only had the opposite effect on LOS in men and women (p = 0.050 and 0.071, respectively). LOS tended to be shorter for men with a wife, but longer for women with a husband. The structure and gender roles in a stroke patient's household may need further attention for the efficient use of hospital resources.

keywords —— gender; family; stroke outcome; hospitalization

===============================

Tohoku J. Exp. Med., 2005, 207, 325-332

Correspondence: Kazuhiro Ohwaki, M.D., Ph.D., Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi, Tokyo 173-8605, Japan.

e-mail: ns-waki@med.teikyo-u.ac.jp