To investigate the clinical characteristics and influencing factors of the length of stay (LOS) for patients with ischemic stroke.

A retrospective study was conducted on ischemic stroke patients hospitalized at Xuanwu Hospital, Capital Medical University, with discharge dates between January 2015 and December 2024. Patients were divided into a long-stay group (LOS ＞ 14 days) and a short-stay group (LOS ≤ 14 days). Standardized data, including demographics, disease diagnoses, and surgical procedures, were collected from the medical record system. Collected variables encompassed discharge year, age, sex, insurance payment method, marital status, mode of arrival, season of onset, surgical procedures, intensive care unit (ICU) admission, discharge disposition, and number of comorbidities. Descriptive analysis, chi-square tests, and univariate and multivariate Logistic regression analyzes were applied to examine the relationship between these factors and LOS.

From 2015 to 2024, a total of 47 285 ischemic stroke patient cases were included, comprising 34 271 males (72.5%) and 13 014 females (27.5%). The median LOS was 8 days (7-11 days). Among them, 43 001 cases (90.9%) had an LOS≤14 days, while 4284 (9.1%) ＞14 days. Significant statistical differences all (P＜0.05) were observed between patients with LOS＞14 days and those with LOS≤14 days regarding age, sex, insurance payment method, marital status, mode of arrival, season of onset, performance of surgeries/procedures, ICU admission, discharge disposition, and number of comorbidities. Multivariate Logistic regression analysis showed that the risk of LOS＞14 days increased by 8.1% for female patients (OR=1.081, 95%CI: 1.000 - 1.167, P=0.049), by 141.7% for unmarried patients (OR=2.417, 95%CI: 1.833 - 3.152, P＜0.001), by 20.9% for winter onset (OR=1.209, 95%CI: 1.097 - 1.332, P＜0.001), by 293.6% for performing surgeries/procedures (OR=3.936, 95%CI: 3.172 - 4.948, P＜0.001), by 835.4% for ICU admission (OR=9.354, 95%CI: 8.563 - 10.219, P＜0.001), and by 55.6% for transfer to another hospital by medical order (OR=1.556, 95%CI: 1.360 - 1.775, P＜0.001). Furthermore, for each additional comorbidity, the risk of LOS＞14 days increased by 9.7% (OR=1.097, 95%CI: 1.090 - 1.103, P＜0.001).

Female sex, unmarried status, winter onset, performance of surgeries/procedures, ICU admission, physician-ordered transfer, and the number of comorbidities are independent risk factors for prolonged LOS in ischemic stroke patients. In the future, the hospital needs to optimize hospitalization risk assessment and intervention strategies for high-risk populations to reduce LOS and improve healthcare service efficiency.