{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:29:35Z","timestamp":1793233775484,"version":"4.5.0"},"reference-count":39,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Stroke rehabilitation is a vital component of post-stroke care, and the length of stay (LOS) in hospitals and rehabilitation centers varies across healthcare systems. This systematic review and meta-analysis assessed LOS among stroke survivors in Arab countries.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>A comprehensive literature search identified studies reporting LOS in stroke rehabilitation. A comprehensive literature search from the inception until March 2025 identified studies reporting LOS in stroke rehabilitation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>A total of 18 publications (25 datasets) involving 12 690 individuals were included in the meta-analysis. The pooled mean LOS was 25.67 days [95% confidence interval (CI): 16.22\u201335.11]. Subgroup analyses showed a longer LOS in Saudi Arabia (37.03 days, 95% CI: 24.11\u201349.95) compared to other Arab countries (8.87 days, 95% CI: 4.90\u201312.84), and in rehabilitation centers (46.71 days, 95% CI: 33.18\u201360.24) compared to acute hospital settings (9.07 days, 95% CI: 5.27\u201312.86). LOS varies widely across Arab countries and care settings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>These findings highlight the need to examine whether differences in LOS are associated with functional recovery and healthcare efficiency. However, substantial heterogeneity across studies and a lack of outcome data limit the interpretability of the results.<\/jats:p>\n          <\/jats:sec>","DOI":"10.5144\/0256-4947.2025.256","type":"journal-article","created":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T06:14:46Z","timestamp":1754201686000},"page":"256-269","source":"Crossref","is-referenced-by-count":3,"title":["Length of stay in hospital and rehabilitation centers after stroke in Arab countries and Saudi Arabia: a systematic review and meta-analysis"],"prefix":"10.5144","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1807-4015","authenticated-orcid":true,"given":"Abdullah I.","family":"Alhusayni","sequence":"first","affiliation":[{"name":"From the Department of Health Rehabilitation, College of Applied Medical Sciences, Shaqra University, Shaqra, Riyadh Province, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah H.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"From the Department of Health Rehabilitation, College of Applied Medical Sciences, Shaqra University, Shaqra, Riyadh Province, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3134","reference":[{"issue":"1","key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12916-019-1397-3","article-title":"Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017","volume":"17","author":"Avan A","year":"2019","unstructured":"Avan A, Digaleh H, Di Napoli M, Stranges S, Behrouz R, Shojaeianbabaei G, et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017. BMC Med. 2019;17(1):1\u201330.","journal-title":"BMC Med"},{"issue":"1","key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1212\/CON.0000000000000423","article-title":"Stroke rehabilitation","volume":"23","author":"Belagaje SR","year":"2017","unstructured":"Belagaje SR. Stroke rehabilitation. Continuum (Minneap Minn). 2017;23(1):238\u201353.","journal-title":"Continuum (Minneap Minn)"},{"issue":"8","key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1097\/01.phm.0000171005.08744.ab","article-title":"Stroke impairment predictors of discharge function, length of stay, and discharge destination in stroke rehabilitation","volume":"84","author":"Wee JY","year":"2005","unstructured":"Wee JY, Hopman WM. Stroke impairment predictors of discharge function, length of stay, and discharge destination in stroke rehabilitation. Am J Phys Med Rehabil. 2005;84(8):604\u201312.","journal-title":"Am J Phys Med Rehabil"},{"issue":"2","key":"e_1_3_2_5_2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1002\/rnj.218","article-title":"Length of stay at inpatient rehabilitation facility and stroke patient outcomes","volume":"41","author":"Camicia M","year":"2016","unstructured":"Camicia M, Wang H, DiVita M, Mix J, Niewczyk P. Length of stay at inpatient rehabilitation facility and stroke patient outcomes. Rehabil Nurs. 2016;41(2):78\u201390.","journal-title":"Rehabil Nurs"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987316654338"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-020-04520-4"},{"issue":"8","key":"e_1_3_2_8_2","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1177\/1747493019851284","article-title":"A national economic and clinical model for ischemic stroke care development in Saudi Arabia: a call for change","volume":"14","author":"Al-Senani F","year":"2019","unstructured":"Al-Senani F, Al-Johani M, Salawati M, ElSheikh S, AlQahtani M, Muthana J, et al. A national economic and clinical model for ischemic stroke care development in Saudi Arabia: a call for change. Int J Stroke. 2019;14(8):835\u201342.","journal-title":"Int J Stroke"},{"issue":"6","key":"e_1_3_2_9_2","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.1161\/STR.0000000000000098","article-title":"Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"47","author":"Winstein CJ","year":"2016","unstructured":"Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. Stroke. 2016;47(6):e98\u2013e169.","journal-title":"Stroke"},{"key":"e_1_3_2_10_2","volume-title":"Semin Neurol","author":"Katan M","year":"2018","unstructured":"Katan M, Luft A, editors. Global burden of stroke. Semin Neurol; 2018: Thieme Medical Publishers."},{"issue":"1","key":"e_1_3_2_11_2","first-page":"29","article-title":"Meta-analysis in medical research","volume":"14","author":"Haidich A-B","year":"2010","unstructured":"Haidich A-B. Meta-analysis in medical research. Hippokratia. 2010;14(Suppl 1):29.","journal-title":"Hippokratia"},{"issue":"4","key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"151","author":"Moher D","year":"2009","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264\u20139.","journal-title":"Ann Intern Med"},{"issue":"1","key":"e_1_3_2_13_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/jebm.12141","article-title":"The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review","volume":"8","author":"Zeng X","year":"2015","unstructured":"Zeng X, Zhang Y, Kwong JS, Zhang C, Li S, Sun F, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med. 2015;8(1):2\u201310.","journal-title":"J Evid Based Med"},{"issue":"1","key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1186\/s12874-024-02356-6","article-title":"Meta-analysis accelerator: a comprehensive tool for statistical data conversion in systematic reviews with meta-analysis","volume":"24","author":"Abbas A","year":"2024","unstructured":"Abbas A, Hefnawy MT, Negida A. Meta-analysis accelerator: a comprehensive tool for statistical data conversion in systematic reviews with meta-analysis. BMC Med Res Methodol. 2024;24(1):243.","journal-title":"BMC Med Res Methodol"},{"key":"e_1_3_2_15_2","doi-asserted-by":"crossref","first-page":"707420","DOI":"10.3389\/fneur.2021.707420","article-title":"Stroke seasonality and weather association in a middle east country: a single tertiary center experience","volume":"12","author":"Alghamdi SA","year":"2021","unstructured":"Alghamdi SA, Aldriweesh MA, Al Bdah BA, Alhasson MA, Alsaif SA, Alluhidan WA, et al. Stroke seasonality and weather association in a middle east country: a single tertiary center experience. Front Neurol. 2021;12:707420.","journal-title":"Front Neurol"},{"key":"e_1_3_2_16_2","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jocn.2020.10.014","article-title":"Characteristics and functional outcomes of pediatric stroke survivors at a rehabilitation unit in Saudi Arabia","volume":"81","author":"Ullah S","year":"2020","unstructured":"Ullah S, Ayaz SB, Qureshi AZ, Tantawy SS, Flandez MF. Characteristics and functional outcomes of pediatric stroke survivors at a rehabilitation unit in Saudi Arabia. J Clin Neurosci. 2020;81:403\u20138.","journal-title":"J Clin Neurosci"},{"issue":"2","key":"e_1_3_2_17_2","doi-asserted-by":"crossref","first-page":"130","DOI":"10.17712\/nsj.2019.2.20180032","article-title":"Falls in individuals with stroke during inpatient rehabilitation at a tertiary care hospital in Saudi Arabia","volume":"24","author":"Ullah S","year":"2019","unstructured":"Ullah S, Al-Atwi MK, Qureshi AZ, Tantawy SS, Ilyas A, Wunderlich CA. Falls in individuals with stroke during inpatient rehabilitation at a tertiary care hospital in Saudi Arabia. Neurosciences (Riyadh). 2019;24(2):130\u20136.","journal-title":"Neurosciences (Riyadh)"},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.12659\/MSM.907452","article-title":"Length of stay and functional outcomes among patients with stroke discharged from an inpatient rehabilitation facility in Saudi Arabia","volume":"24","author":"Bindawas SM","year":"2018","unstructured":"Bindawas SM, Vennu V, Mawajdeh H, Alhaidary HM, Moftah E. Length of stay and functional outcomes among patients with stroke discharged from an inpatient rehabilitation facility in Saudi Arabia. Med Sci Monit. 2018;24:207.","journal-title":"Med Sci Monit"},{"key":"e_1_3_2_19_2","unstructured":"Qureshi AZ Ullah S Jenkins RM Janjua SH editors. Length of hospital stay during stroke rehabilitation at a tertiary care rehabilitation center in Saudi Arabia. Med Forum Mon; 2018."},{"key":"e_1_3_2_20_2","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.2147\/CIA.S145402","article-title":"Functional outcomes by age after inpatient stroke rehabilitation in Saudi Arabia","author":"Bindawas SM","year":"2017","unstructured":"Bindawas SM, Vennu V, Mawajdeh H, Alhaidary H. Functional outcomes by age after inpatient stroke rehabilitation in Saudi Arabia. Clin Interv Aging. 2017:1791\u20137.","journal-title":"Clin Interv Aging"},{"issue":"31","key":"e_1_3_2_21_2","doi-asserted-by":"crossref","first-page":"e4432","DOI":"10.1097\/MD.0000000000004432","article-title":"A retrospective observational study of functional outcomes, length of stay, and discharge disposition after an inpatient stroke rehabilitation program in Saudi Arabia","volume":"95","author":"Bindawas SM","year":"2016","unstructured":"Bindawas SM, Mawajdeh H, Vennu V, Alhaidary H. A retrospective observational study of functional outcomes, length of stay, and discharge disposition after an inpatient stroke rehabilitation program in Saudi Arabia. Medicine (Baltimore). 2016;95(31):e4432.","journal-title":"Medicine (Baltimore)"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2016.197"},{"issue":"9","key":"e_1_3_2_23_2","first-page":"993","article-title":"The impact of \u201cadmit no bed\u201d and long boarding times in the emergency department on stroke outcome","volume":"35","author":"Al-Khathaami AM","year":"2014","unstructured":"Al-Khathaami AM, Abulaban AA, Mohamed GE, Alamry AM, Kojan SM, Aljumah MA. The impact of \u201cadmit no bed\u201d and long boarding times in the emergency department on stroke outcome. Saudi Med J. 2014;35(9):993\u20138.","journal-title":"Saudi Med J"},{"issue":"3","key":"e_1_3_2_24_2","first-page":"326","article-title":"Length of stay of patients in different rehabilitation programs. A hospital experience in Saudi Arabia","volume":"33","author":"Al-Jadid MS","year":"2012","unstructured":"Al-Jadid MS, Robert AA. Length of stay of patients in different rehabilitation programs. A hospital experience in Saudi Arabia. Saudi Med J. 2012;33(3):326\u20137.","journal-title":"Saudi Med J"},{"issue":"2","key":"e_1_3_2_25_2","first-page":"189","article-title":"Determinants of length of stay in an inpatient stroke rehabilitation unit in Saudi Arabia","volume":"31","author":"Al-Jadid MS","year":"2010","unstructured":"Al-Jadid MS, Robert AA. Determinants of length of stay in an inpatient stroke rehabilitation unit in Saudi Arabia. Saudi Med J. 2010;31(2):189\u201392.","journal-title":"Saudi Med J"},{"key":"e_1_3_2_26_2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jocn.2024.03.014","article-title":"Epidemiological profile of stroke in Qatar: Insights from a seven-year observational study","volume":"123","author":"Bhutta ZA","year":"2024","unstructured":"Bhutta ZA, Akhtar N, Pathan SA, Castren M, Harris T, Ganesan GS, et al. Epidemiological profile of stroke in Qatar: Insights from a seven-year observational study. J Clin Neurosci. 2024;123:30\u20135.","journal-title":"J Clin Neurosci"},{"issue":"1","key":"e_1_3_2_27_2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5339\/qmj.2022.10","article-title":"Post-COVID-19 stroke rehabilitation in Qatar: a retrospective, observational pilot study","volume":"2022","author":"Asirvatham T","year":"2022","unstructured":"Asirvatham T, Abubacker M, Isaac Chandran P, Boppana A, Salim Al Abdulla S, Mohammed Saad R. Post-COVID-19 stroke rehabilitation in Qatar: a retrospective, observational pilot study. Qatar Med J. 2022;2022(1):10.","journal-title":"Qatar Med J"},{"issue":"2","key":"e_1_3_2_28_2","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1159\/000507193","article-title":"Sex-specific differences in short-term and long-term outcomes in acute stroke patients from Qatar","volume":"83","author":"Akhtar N","year":"2020","unstructured":"Akhtar N, Kate M, Kamran S, Singh R, Bhutta Z, Saqqur M, et al. Sex-specific differences in short-term and long-term outcomes in acute stroke patients from Qatar. Eur Neurol. 2020;83(2):154\u201361.","journal-title":"Eur Neurol"},{"issue":"12","key":"e_1_3_2_29_2","doi-asserted-by":"crossref","first-page":"3494","DOI":"10.1161\/STROKEAHA.115.010552","article-title":"Beneficial effects of implementing stroke protocols require establishment of a geographically distinct unit","volume":"46","author":"Akhtar N","year":"2015","unstructured":"Akhtar N, Kamran S, Singh R, Cameron P, D'Souza A, Imam Y, et al. Beneficial effects of implementing stroke protocols require establishment of a geographically distinct unit. Stroke. 2015;46(12):3494\u2013501.","journal-title":"Stroke"},{"issue":"1","key":"e_1_3_2_30_2","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1100\/tsw.2008.81","article-title":"Length of Stay in In-Patient Rehabilitation after Stroke in Qatar","volume":"8","author":"Venkatachalm L","year":"2008","unstructured":"Venkatachalm L, Georgievski AB, Al Yazeedi W, Singh R, Garrido HU. Length of Stay in In-Patient Rehabilitation after Stroke in Qatar. Sci World J. 2008;8(1):547\u201355.","journal-title":"Sci World J"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2022.269"},{"issue":"4","key":"e_1_3_2_32_2","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.4103\/0028-3886.236973","article-title":"Early post-stroke seizures in a sample of Egyptian patients with first-ever stroke","volume":"66","author":"Shehta N","year":"2018","unstructured":"Shehta N, Fahmi RM, Ramadan BM, Emad EM, Elsaid AF. Early post-stroke seizures in a sample of Egyptian patients with first-ever stroke. Neurol India. 2018;66(4):1031\u20135.","journal-title":"Neurol India"},{"issue":"9458","key":"e_1_3_2_33_2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/S0140-6736(05)17868-4","article-title":"Early supported discharge services for stroke patients: a meta-analysis of individual patients' data","volume":"365","author":"Langhorne P","year":"2005","unstructured":"Langhorne P, Taylor G, Murray G, Dennis M, Anderson C, Bautz-Holter E, et al. Early supported discharge services for stroke patients: a meta-analysis of individual patients' data. Lancet. 2005;365(9458):501\u20136.","journal-title":"Lancet"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.3233\/nre-161425"},{"issue":"1","key":"e_1_3_2_35_2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.4103\/ATMR.ATMR_98_24","article-title":"Comparative Analysis of Inpatient and Outpatient Stroke Rehabilitation Programs in Saudi Arabia: A Cross-Sectional Study","volume":"1","author":"Alshakhs ZM","year":"2024","unstructured":"Alshakhs ZM, Alohali RM, Alshakhs MA, Alanazi RF, Alarifi AI, Alshargi MA, et al. Comparative Analysis of Inpatient and Outpatient Stroke Rehabilitation Programs in Saudi Arabia: A Cross-Sectional Study. J Adv Trends Med Res. 2024;1(1):329\u201336.","journal-title":"J Adv Trends Med Res"},{"issue":"7","key":"e_1_3_2_36_2","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1001\/jamaneurol.2015.0284","article-title":"Care and outcomes of patients with in-hospital stroke","volume":"72","author":"Saltman AP","year":"2015","unstructured":"Saltman AP, Silver FL, Fang J, Stamplecoski M, Kapral MK. Care and outcomes of patients with in-hospital stroke. JAMA Neurol. 2015;72(7):749\u201355.","journal-title":"JAMA Neurol"},{"issue":"1","key":"e_1_3_2_37_2","first-page":"26","article-title":"Healthcare resource utilization and clinical outcomes associated with acute care and inpatient rehabilitation of stroke patients in Japan","volume":"29","author":"Murata K","year":"2017","unstructured":"Murata K, Hinotsu S, Sadamasa N, Yoshida K, Yamagata S, Asari S, et al. Healthcare resource utilization and clinical outcomes associated with acute care and inpatient rehabilitation of stroke patients in Japan. Int J Qual Health Care. 2017;29(1):26\u201331.","journal-title":"Int J Qual Health Care"},{"issue":"6","key":"e_1_3_2_38_2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.phrp.2013.10.008","article-title":"Determinants of the length of stay in stroke patients","volume":"4","author":"Kim SM","year":"2013","unstructured":"Kim SM, Hwang SW, Oh E-H, Kang J-K. Determinants of the length of stay in stroke patients. Osong Public Health Res Perspect. 2013;4(6):329\u201341.","journal-title":"Osong Public Health Res Perspect"},{"key":"e_1_3_2_39_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-019-4654-4","article-title":"Scoping review of acute stroke care management and rehabilitation in low and middle-income countries","volume":"19","author":"Chimatiro GL","year":"2019","unstructured":"Chimatiro GL, Rhoda AJ. Scoping review of acute stroke care management and rehabilitation in low and middle-income countries. BMC Health Serv Res. 2019;19:1\u201315.","journal-title":"BMC Health Serv Res"},{"key":"e_1_3_3_2_8_16_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138237"}],"container-title":["Annals of Saudi Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T07:41:26Z","timestamp":1754379686000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.annsaudimed.net\/doi\/10.5144\/0256-4947.2025.256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.5144\/0256-4947.2025.256"],"URL":"https:\/\/doi.org\/10.5144\/0256-4947.2025.256","relation":{},"ISSN":["0256-4947","0975-4466"],"issn-type":[{"value":"0256-4947","type":"print"},{"value":"0975-4466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}