【Cerebral Infarction Hospital Stay】The 90−120 Day Process: Acute/Recovery Phase Transfer and Rehabilitation Duration

One of the major concerns for patients and families following a cerebral infarction is the question of “how long the hospital stay will be.” As of 2025, stroke treatment in Japan is typically divided into two phases: “Acute Hospital Treatment” and “Intensive Training at a Recovery Rehabilitation Ward.” The most common scenario involves a total hospital stay of approximately 90−120 days.

Cerebral Infarction Hospital Stay Duration

Severity of Stroke	Average Hospital Stay (2023–2025 Data)	Typical Flow of Hospitalization
Mild (Walks in, minor symptoms)	7−14 days	Acute Hospital → Discharge home directly
Moderate (Hemiplegia, cannot walk but conscious)	21−45 days	Acute Hospital (≈2−3 weeks) → Transfer to Recovery Rehabilitation Hospital
Severe (Conscious disorder, post-thrombectomy, etc.)	45−120 days or more	Acute Hospital (≈3−6 weeks) → Recovery Rehab →Maintenance facility if necessary
Ultra-Severe (Bedridden, pneumonia complications, etc.)	6 months to ≥1 year	Long-term care facility or Nursing Home (Rōken)

Estimated Average Days (National Average, 2025)

Type of Hospital	Average Length of Stay	Notes
Acute Hospital(SCU/Stroke Center)	10−21 days	Diagnosis, treatment, and initial rehabilitation.
Recovery Rehabilitation Ward	60−150 days	Maximum 9 units (3 hours) of rehab per day. 150 days is the insurance limit(Can be extended to 180 days for cardioembolic cases).
Total (Standard Moderate Course)	≈90−120days	The most common pattern in Japan.

Factors Shortening / Lengthening the Stay

Factors Shortening Stay	Factors Lengthening Stay
* Age under 70	* Age over 80
* Treatment started within 4.5 hours of onset	* Delayed treatment
* Successful thrombectomy	* Severe condition (mRS 4−5)
* Strong family caregiving ability	* Requires gastronomy tube for dysphagia
* Able to sit/stand early	* Recurrent pneumonia or urinary tract infection
	* Co-existing dementia

2025 New Trends

Home Discharge Rate is Rising: Many hospitals specializing in rehabilitation achieve a home discharge rate of over 80% by utilizing the full 150-day recovery period.
Combined Home + Outpatient Rehab: Systems are in place to allow rehab 5−7 times per week after discharge, helping to shorten the inpatient stay.
Robot/AI Rehabilitation: Hospitals implementing advanced technology see an average reduction of 10−20 days in the length of stay due to increased efficiency.

Practical Discharge Guidelines (Guidance for Families)

Condition	Discharge Guideline
Can walk to the restroom independently	Direct discharge home from the Acute Hospital (≈2−3 weeks).
Wheelchair user but independent transfer	Discharge home often occurs after 60−90 days in the Recovery Ward.
Bedridden + G-tube + Tracheostomy	Home discharge is difficult even after 150 days in the Recovery Ward → Transfer to a Long-term Care Facility or Nursing Home.