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TRENDS AND PREDICTORS OF LENGTH OF STAY AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION: A REPORT FROM THE NATIONAL CARDIOVASCULAR DATA REGISTRY
A113.E1054 JACC March 9, 2010 Volume 55, issue 10A
MYOCARDIAL ISCHEMIA AND INFARCTION TRENDS AND PREDICTORS OF LENGTH OF STAY AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION: A REPORT FROM THE NATIONAL CARDIOVASCULAR DATA REGISTRY ACC Poster Contributions Georgia World Congress Center, Hall B5 Monday, March 15, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Outcomes after Percutaneous Coronary Intervention Abstract Category: Unstable Ischemic Syndrome--Clinical Presentation Number: 1153-262 Authors: Chee Tang Chin, Tracy Y. Wang, David Dai, Matthew T. Roe, Rajendra H. Mehta, John S. Rumsfeld, H. Vernon Anderson, William S. Weintraub, John C. Messenger, Michael A. Kutcher, Ralph G. Brindis, Eric D. Peterson, Robert A. Harrington, Sunil V. Rao, Duke Clinical Research Institute, Durham, NC Background: Post-hoc analyses of recent clinical trials suggest that certain patients are eligible for early discharge after primary percutaneous coronary intervention (PPCI). The extent to which patients are discharged early after PPCI in clinical practice is unknown. Methods: We examined patients in the NCDR CathPCI Registry (N = 115,113) to assess temporal trends in length of stay (LOS) after PPCI. Baseline patient, procedural, and hospital characteristics were compared between patients with LOS ≤ 2 and > 2 days. Predictors of early discharge (LOS ≤ 2 days) were determined by logistic regression and adjusted to account for clustering among centers. Results: Median age was 59 years and 27.2% were female. From Jul 2004 through Mar 2009, mean LOS decreased from 4.1 ± 3.1 to 3.6 ± 2.7 days, p < 0.0001 (Figure).
Patients with LOS ≤ 2 days (n = 37,642; 32.7% of patients with PPCI) were younger, more likely male and Caucasian. They were less likely to have co-morbidities and heart failure or cardiogenic shock on presentation and more likely to have successful and uncomplicated PPCI. The factors most strongly associated with LOS ≤ 2 days were age, no IABP usage, absence of cardiogenic shock, no blood products used and no post PPCI complications. Conclusions: Over the period examined, there has been a significant decrease in LOS after PPCI. LOS ≤ 2 days is associated with specific patient, procedure and hospital factors. Further study is needed to determine the safety of early discharge among patients meeting these criteria.
MYOCARDIAL ISCHEMIA AND INFARCTION TRENDS AND PREDICTORS OF LENGTH OF STAY AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION: A REPORT FROM THE NATIONAL CARDIOVASCULAR DATA REGISTRY ACC Poster Contributions Georgia World Congress Center, Hall B5 Monday, March 15, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Outcomes after Percutaneous Coronary Intervention Abstract Category: Unstable Ischemic Syndrome--Clinical Presentation Number: 1153-262 Authors: Chee Tang Chin, Tracy Y. Wang, David Dai, Matthew T. Roe, Rajendra H. Mehta, John S. Rumsfeld, H. Vernon Anderson, William S. Weintraub, John C. Messenger, Michael A. Kutcher, Ralph G. Brindis, Eric D. Peterson, Robert A. Harrington, Sunil V. Rao, Duke Clinical Research Institute, Durham, NC Background: Post-hoc analyses of recent clinical trials suggest that certain patients are eligible for early discharge after primary percutaneous coronary intervention (PPCI). The extent to which patients are discharged early after PPCI in clinical practice is unknown. Methods: We examined patients in the NCDR CathPCI Registry (N = 115,113) to assess temporal trends in length of stay (LOS) after PPCI. Baseline patient, procedural, and hospital characteristics were compared between patients with LOS ≤ 2 and > 2 days. Predictors of early discharge (LOS ≤ 2 days) were determined by logistic regression and adjusted to account for clustering among centers. Results: Median age was 59 years and 27.2% were female. From Jul 2004 through Mar 2009, mean LOS decreased from 4.1 ± 3.1 to 3.6 ± 2.7 days, p < 0.0001 (Figure).
Patients with LOS ≤ 2 days (n = 37,642; 32.7% of patients with PPCI) were younger, more likely male and Caucasian. They were less likely to have co-morbidities and heart failure or cardiogenic shock on presentation and more likely to have successful and uncomplicated PPCI. The factors most strongly associated with LOS ≤ 2 days were age, no IABP usage, absence of cardiogenic shock, no blood products used and no post PPCI complications. Conclusions: Over the period examined, there has been a significant decrease in LOS after PPCI. LOS ≤ 2 days is associated with specific patient, procedure and hospital factors. Further study is needed to determine the safety of early discharge among patients meeting these criteria.