Factors associated with length of stay among patients with acute myocardial infarction undergoing percutaneous coronary intervention: findings from the CCC-ACS project
Chengran Wang, Zesheng Xu, Yong Chen HaoObjective
Prolonged length of stay (LOS) contributes substantially to the healthcare burden in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), yet large-scale evidence from Chinese populations remains limited. This study aimed to identify factors associated with prolonged LOS among AMI patients undergoing PCI.
Methods
Data were derived from the nationwide CCC-ACS (Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome) registry (November 2014 to December 2020). A total of 70 209 AMI patients aged 18–80 years undergoing PCI were included. Prolonged LOS was defined as >75th percentile. Multivariable logistic regression was used to identify independent predictors. Temporal trends in LOS from 2015 to 2020 were also assessed. Patients were further stratified by five pre-admission risk factors to assess dose–response relationships.
Results
LOS decreased in ST-segment elevation myocardial infarction from 2015 to 2017 but remained stable thereafter, with no significant change in non-ST-segment elevation myocardial infarction. Female sex (OR=0.823), prior PCI (OR=0.745) and hyperlipidaemia (OR=0.917) were associated with a lower risk of prolonged LOS, whereas older age (OR=1.013), prior heart failure (OR=2.230), diabetes (OR=1.140) and transient ischaemic attack (OR=1.341) were independently associated with an increased risk of prolonged LOS (all p<0.05). A significant dose–response relationship was observed, with higher risk associated with increasing numbers of risk factors.
Conclusion
Prolonged LOS among AMI patients undergoing PCI was associated with both baseline characteristics and in-hospital factors, with a clear cumulative effect, which may aid risk stratification and optimisation of in-hospital management.
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