Identifying Factors that Influence the Length of Stay in Patients with Non-ST Segment Elevation Acute Coronary Syndrome in Siriraj Hospital
Jithathai Suksamai RN*, Nongnuch Neakeaw RN*, Tanomsri Daengsri RN*, Daranee Pongsana RN*, Satchana Pumprueg MD**
Affiliation : * Division of Medicine and Psychology Nursing, Department of Nursing, Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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.
Keywords : Non-ST-segment elevation myocardial infarction, Length of stay, Reimbursement policy
