Predictors of length of stay after coronary stenting

Herbert D. Aronow, Patricia A. Peyser, Kim A. Eagle, Eric R. Bates, Steven W. Werns, Pamela L. Russman, Martha A. Crum, Kathi Harris, Mauro Moscucci

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: Postprocedure length of stay (LOS) remains an important determinant of medical costs after coronary stenting. Variables that predict LOS in this setting have not been well characterized. Methods: We evaluated 359 consecutive patients who underwent coronary stenting with antiplatelet therapy. Sequential multiple linear regression (MLR) models were constructed with use of 4 types of variables to predict log-transformed LOS: preprocedure, intraprocedure, and postprocedure factors and adverse outcomes. Results: Preprocedure factors alone explained more than one third of the variability in postprocedure LOS (adjusted R2 = 0.37). The addition of procedural variables added little to the model (adjusted R2 = 0.39). Entering nonoutcome postprocedure variables significantly enhanced the predictive capacity of the model, explaining more than half the variability in postprocedure LOS (adjusted R2 = 0.54). In the final model, addition of outcome variables increased its predictive capacity only slightly (adjusted R2 = 0.61). In this model, significant preprocedure factors included: myocardial infarction (MI) within 24 hours, MI within 1 to 30 days, women with peripheral vascular disease, intravenous heparin, and chronic atrial fibrillation. High-risk intervention was the only significant intraprocedure variable. Significant postprocedure factors included periprocedure ischemia; cerebrovascular accident or transient ischemic attack; treatment with intravenous heparin or nitroglycerin or intra-aortic balloon pump; and need for blood transfusion. Significant adverse outcomes included contrast nephropathy, gastrointestinal bleeding, arrhythmia, vascular complication, and repeat angiography. Conclusion: This prediction model identifies a number of potentially reversible factors responsible for prolonging LOS and may enable the development of more accurate risk-adjusted methods with which to improve or compare care.

Original languageEnglish
Pages (from-to)799-805
Number of pages7
JournalAmerican Heart Journal
Volume142
Issue number5
DOIs
StatePublished - Nov 10 2001

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Length of Stay
Heparin
Linear Models
Myocardial Infarction
Peripheral Vascular Diseases
Transient Ischemic Attack
Nitroglycerin
Blood Transfusion
Atrial Fibrillation
Blood Vessels
Cardiac Arrhythmias
Angiography
Ischemia
Stroke
Hemorrhage
Costs and Cost Analysis
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Aronow, H. D., Peyser, P. A., Eagle, K. A., Bates, E. R., Werns, S. W., Russman, P. L., ... Moscucci, M. (2001). Predictors of length of stay after coronary stenting. American Heart Journal, 142(5), 799-805. https://doi.org/10.1067/mhj.2001.119371

Predictors of length of stay after coronary stenting. / Aronow, Herbert D.; Peyser, Patricia A.; Eagle, Kim A.; Bates, Eric R.; Werns, Steven W.; Russman, Pamela L.; Crum, Martha A.; Harris, Kathi; Moscucci, Mauro.

In: American Heart Journal, Vol. 142, No. 5, 10.11.2001, p. 799-805.

Research output: Contribution to journalArticle

Aronow, HD, Peyser, PA, Eagle, KA, Bates, ER, Werns, SW, Russman, PL, Crum, MA, Harris, K & Moscucci, M 2001, 'Predictors of length of stay after coronary stenting', American Heart Journal, vol. 142, no. 5, pp. 799-805. https://doi.org/10.1067/mhj.2001.119371
Aronow HD, Peyser PA, Eagle KA, Bates ER, Werns SW, Russman PL et al. Predictors of length of stay after coronary stenting. American Heart Journal. 2001 Nov 10;142(5):799-805. https://doi.org/10.1067/mhj.2001.119371
Aronow, Herbert D. ; Peyser, Patricia A. ; Eagle, Kim A. ; Bates, Eric R. ; Werns, Steven W. ; Russman, Pamela L. ; Crum, Martha A. ; Harris, Kathi ; Moscucci, Mauro. / Predictors of length of stay after coronary stenting. In: American Heart Journal. 2001 ; Vol. 142, No. 5. pp. 799-805.
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N2 - Background: Postprocedure length of stay (LOS) remains an important determinant of medical costs after coronary stenting. Variables that predict LOS in this setting have not been well characterized. Methods: We evaluated 359 consecutive patients who underwent coronary stenting with antiplatelet therapy. Sequential multiple linear regression (MLR) models were constructed with use of 4 types of variables to predict log-transformed LOS: preprocedure, intraprocedure, and postprocedure factors and adverse outcomes. Results: Preprocedure factors alone explained more than one third of the variability in postprocedure LOS (adjusted R2 = 0.37). The addition of procedural variables added little to the model (adjusted R2 = 0.39). Entering nonoutcome postprocedure variables significantly enhanced the predictive capacity of the model, explaining more than half the variability in postprocedure LOS (adjusted R2 = 0.54). In the final model, addition of outcome variables increased its predictive capacity only slightly (adjusted R2 = 0.61). In this model, significant preprocedure factors included: myocardial infarction (MI) within 24 hours, MI within 1 to 30 days, women with peripheral vascular disease, intravenous heparin, and chronic atrial fibrillation. High-risk intervention was the only significant intraprocedure variable. Significant postprocedure factors included periprocedure ischemia; cerebrovascular accident or transient ischemic attack; treatment with intravenous heparin or nitroglycerin or intra-aortic balloon pump; and need for blood transfusion. Significant adverse outcomes included contrast nephropathy, gastrointestinal bleeding, arrhythmia, vascular complication, and repeat angiography. Conclusion: This prediction model identifies a number of potentially reversible factors responsible for prolonging LOS and may enable the development of more accurate risk-adjusted methods with which to improve or compare care.

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