Identifying factors that influence the length of stay in patients with non-st segment elevation acute coronary syndrome in Siriraj Hospital

Abstract

© 2015, Medical Association of Thailand. All rights reserved. Objective: Acute coronary syndrome is a leading cause of hospitalization from cardiac disease. The Siriraj NSTE-ACS registry was developed in 2012 as a single center registry. This study purpose is to identify factors affecting the length of stay of the patients in the registry. Material and Method: From January 2012 to March 2013, 130 patients were enrolled consecutively. The patients were classified into two groups; patients with length of stay >5 days, and a group of patients with length of stay ≤5 days. Comparison of variables of interest among the patient groups was performed using appropriate statistic Results: There were 130 patients in the study. Males were predominate (56.9%). More than 80% of the patients were classified as high-risk based on TIMI risk score ≥3. Most patients (64.6%) had LOS >5 days. Among various variables, coronary angiogram during admission, heart failure at presentation, and GRACE risk score >130 were associated with LOS >5 days with the odds ratio of 4.05, 4.34, and 3.23, respectively. Reimbursement policy also had impact on LOS. Using universal coverage as a reference, odds ratio for LOS >5 days for government paid policy and self paid/private insurance policy were 0.28 and 0.05, respectively. Conclusion: Factors affecting LOS include CAG during admission, reimbursement policy, heart failure at presentation, and the GRACE risk score >130. Heart failure at presentation had highest impact on length of stay with an adjusted odds ratio of 4.34.