Modeling of Factors Affecting Hospital Length of Stay in ST-Elevation Patients Using Logistic Regression Models: SEMI CI Study

Abstract

Background: Ischemic heart disease is a prevalent condition. The length of stay (LOS) for ST-elevation myocardial infarction (STEMI) patients is related to healthcare costs and resources. This study aims to determine the underlying risk factors for longer LOS in STEMI patients at Chamran Hospital, Isfahan, Iran. Materials and Methods: In this study, which is part of the STEMI cohort study (SEMI-CI) in Isfahan, Iran, patients with STEMI admitted to Chamran Hospital from March 2015 to March 2016 were identified. The association between risk factors and LOS was evaluated by trained nurses using medical archives. Logistic regression analysis identified independent predictors of LOS. Data were analyzed using SPSS Statistics 22 (IBM, Inc., Armonk, NY, USA), and the significance level was set at an alpha value of <0.05. Results: Of 867 STEMI patients, 760 had complete information. The median LOS for surviving patients was three days. Patients with longer hospitalization times were predominantly older, more likely to be female, had lower left ventricular ejection fraction (LVEF) and hemoglobin, a history of cardiovascular diseases (CVD), hypertension, and heart failure, and had previously used beta-blockers, statins, aspirin, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. The results of logistic regression models showed that higher low-density lipoprotein cholesterol (LDL-C) (P = 0.032), lower hemoglobin (P = 0.004), and lower LVEF (P = 0.019) were three risk factors for increased length of hospitalization. Conclusion: Identifying and controlling the factors affecting the LOS of STEMI patients (such as LDL-C, hemoglobin levels, and LVEF) can help reduce LOS, decrease the overuse of medical resources, and improve patient recovery.