Factors associated with length of stay among patients with acute myocardial infarction undergoing percutaneous coronary intervention: findings from the CCC-ACS project.

OBJECTIVE

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.

TRIAL REGISTRATION NUMBER: NCT02306616.