Key result
Having ≥4 pre-admission risk factors is linked to ~150% higher risk of prolonged LOS after PCI.
Why the study?
Prolonged length of stay contributes substantially to healthcare burden in AMI patients undergoing PCI, but large-scale evidence from Chinese populations remains limited.
Observational (n=70,209)
Yes
Odds Ratio: 2.502 (95% CI 1.905–3.285)
p-value: p=<0.001
Prolonged hospital length of stay following PCI for acute myocardial infarction is strongly driven by cumulative baseline comorbidities, particularly prior heart failure, highlighting the need for early risk stratification.
Identifies factors linked to prolonged LOS after AMI-PCI in China; hypothesis-generating and leaves open whether targeted interventions reduce burden.
OBJECTIVE: Prolonged length of stay (LOS) contributes substantially to the healthcare burden in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), yet large-scale evidence from Chinese populations remains limited. This study aimed to identify factors associated with prolonged LOS among AMI patients undergoing PCI. METHODS: Data were derived from the nationwide CCC-ACS (Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome) registry (November 2014 to December 2020). A total of 70 209 AMI patients aged 18-80 years undergoing PCI were included. Prolonged LOS was defined as >75th percentile. Multivariable logistic regression was used to identify independent predictors. Temporal trends in LOS from 2015 to 2020 were also assessed. Patients were further stratified by five pre-admission risk factors to assess dose-response relationships. RESULTS: LOS decreased in ST-segment elevation myocardial infarction from 2015 to 2017 but remained stable thereafter, with no significant change in non-ST-segment elevation myocardial infarction. Female sex (OR=0.823), prior PCI (OR=0.745) and hyperlipidaemia (OR=0.917) were associated with a lower risk of prolonged LOS, whereas older age (OR=1.013), prior heart failure (OR=2.230), diabetes (OR=1.140) and transient ischaemic attack (OR=1.341) were independently associated with an increased risk of prolonged LOS (all p<0.05). A significant dose-response relationship was observed, with higher risk associated with increasing numbers of risk factors. CONCLUSION: Prolonged LOS among AMI patients undergoing PCI was associated with both baseline characteristics and in-hospital factors, with a clear cumulative effect, which may aid risk stratification and optimisation of in-hospital management. TRIAL REGISTRATION NUMBER: NCT02306616.
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Wang et al. (2026) conducted an observational in Acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) (n=70,209). ≥4 pre-admission risk factors (age >75, hypertension, diabetes, history of heart failure, TIA) vs. 0 pre-admission risk factors was evaluated on Prolonged length of stay (>75th percentile, >12 days) (OR 2.502, 95% CI 1.905-3.285, p=<0.001). Having ≥4 pre-admission risk factors significantly increased the risk of prolonged length of stay compared to having no risk factors (OR 2.502) among AMI patients undergoing PCI.
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