Predictors of length of stay after coronary stenting

Background Postprocedure length of stay (LOS) remains an important determin ant 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 stenti ng with antiplatelet therapy. Sequential multiple linear regression (MLR) m odels were constructed with use of 4 types of variables to predict log-tran sformed LOS: preprocedure, intraprocedure, and postprocedure factors and ad verse outcomes. Results Preprocedure factors alone explained more than one third of the var iability in postprocedure LOS (adjusted R-2 = 0.37). The addition of proced ural variables added little to the model (adjusted R-2 = 0.39). Entering no noutcome postprocedure variables significantly enhanced the predictive capa city of the model, explaining more than half the variability in postprocedu re LOS (adjusted R-2 = 0.54). In the final model, addition of outcome varia bles increased its predictive capacity only slightly (adjusted R-2 = 0.61). In this model, significant preprocedure factors included: myocardial infar ction (MI) within 24 hours, MI within 1 to 30 days, women with peripheral v ascular disease, intravenous heparin, and chronic atrial fibrillation. High -risk intervention was the only significant intraprocedure variable. Signif icant postprocedure factors included periprocedure ischemia; cerebrovascula r accident or transient ischemic attack; treatment with intravenous heparin or nitroglycerin or intra-aortic balloon pump; and need for blood transfus ion. Significant adverse outcomes included contrast, nephropathy, gastroint estinal bleeding, arrhythmia, vascular complication, and repeat angiography . Conclusion This prediction model identifies a number of potentially reversi ble factors responsible for prolonging LOS. and may enable the development of more accurate risk-adjusted methods with which to improve or compare car e.