Association between abciximab and length of stay in intensive care for patients undergoing percutaneous coronary intervention - A 2-stage econometricmodel in a naturalistic setting

Objective: To examine the effect of abciximab treatment on intensive care l ength of stay for patients undergoing percutaneous coronary intervention (P CI). Design and setting: A retrospective study conducted in a naturalistic setti ng. Methods: A 2-stage econometric model was used to control for the influence of possible selection bias across categories of patients and for both obser vable and unobservable factors correlated with each patient's treatment sel ection and length of stay in intensive care. Multivariate analysis was appl ied to control for a wide range of factors (patient demographics, insurance provider, health conditions, admission and discharge information, and hosp ital characteristics) that may influence intensive care length of stay. Ret rospective data were obtained from HCIA's Clinical Pathways Database. Participants: Patients (n = 13 364) who were hospitalised in any of 87 hosp itals across the US over the period from October 1, 1995 to December 1, 199 6. Results: After controlling for high-risk indications and selection bias, re sults indicated that: administration of abciximab was associated with a sig nificantly shorter length of stay in intensive care compared with not admin istering a GPIIb/ IIIa inhibitor (0.45 fewer days; p less than or equal to 0.0001). In a subgroup analysis of patients having an acute myocardial infa rction (n = 4793), administration of abciximab was also associated with a s ignificantly shorter intensive care stay (0.27 fewer days; p < 0.0001). Conclusion: Results of this study indicate that the administration of abcix imab is associated with a reduction in the length of stay in intensive care . This reduction implies potential cost offsets for patients undergoing PCI who receive abciximab.