PREOPERATIVE FACTORS THAT PREDICT HOSPITAL LENGTH OF STAY AFTER DISTAL ARTERIAL BYPASS

Purpose: The purpose of this study was to identify the preoperative fa ctors that are predictive of prolonged hospital length of stay (LOS) a nd to discuss strategies that might assist in minimizing LOS for this select group of patients. Methods: Two hundred seventy-five arterial b ypass procedures with the in situ technique were performed between 198 6 and 1993. The relationship between 14 preoperative variables and hos pital LOS was analyzed with both univariate (Kaplan-Meier) and multiva riate (Cox regression) statistical techniques. A model was developed t o determine the significant preoperative variables that were associate d with prolonged LOS. Results: The primary and secondary patency rates and limb salvage rates at 4 years were 73.3% +/- 3.2%, 78.9% +/- 2.9% , and 81.9% +/- 3.2%, respectively. The median postoperative LOS was 1 5 days, with a mean +/- SD of 17.8 +/- 12.3 days (range 4 to 93 days). With Cox regression analysis, the variables that were significant pre dictors of LOS (with a model p value < 0.002) were age (greater than 7 4 years vs less than 75), history of cerebrovascular disease (transien t ischemic attack, stroke, past carotid endarterectomy vs nil), and op erative indication (limb salvage vs disabling claudication). Conclusio ns: This study illustrates that certain preoperative variables are pre dictive of prolonged postoperative LOS after in situ bypass. The signi ficant preoperative factors identified should be used to direct specif ic care and discharge planning for these individuals.