1017-74 Length of Hospital Stay After Percutaneous Transluminal Coronary Angioplasty: Clinical and Angiographic Predictors

Although several studies have shown that the complications of percutaneous transluminal coronary angioplasty (PTCA) are related to baseline clinical and angiographic variables, it is uncertain whether the utilization of hospital resources after PTCA also depends on the same characteristics. The purpose of this study was to identify the factors responsible f·or prolonged hospital stay ILOS) after PTCA. In 591 consecutive patients undergoing PTCA at nine centers in North America, major or minor complications occurred in 91 patients (15.4%1 and were found to be related to the presence of multivessel disease (p=0.02). unstable angina (p=0.02). and advanced age (p=0.002) on multivariable logistic regression analysis. As compared with a median length of stay of 2.0 days (2.0, 4.0 [25th, 75th percentiles]) for 500 patients (84.6%) after uncomplicated PTCA, the length of stay was 9.0 days (8.0, 18.01 for 19 patients (3.2%) requiring emergency bypass surgery (P<0.001), and 6.0 days (3.0,10.5) for 65 patients 111.0%) with established or threatened abrupt closure (P<0.0011. On stepwise multilinear regression analysis, however, no significant relation was found between LOS and baseline variables; instead, LOS was increased only by PTCA complications:Variable IncreaseIncrease in LOS (days±SEM)PEmergency CABG9.5±1.1<0.001Death7.7±1.4<0.001Myocardial infarction29±09<0.001Abrupt closure29±06<0.001Age0.040.32Female sex-0.010.99Unstable angina0.600.15Multivessel disease0.080.17Complex lesion0.290.2In conclusion, efforts directed at reducing resource utilization after PTCA should focus on the development of new techniques to lower PTCA complications rather than limit the access of patients with advanced age and complex lesions to PTCA