Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec;6(23):454.
doi: 10.21037/atm.2018.11.10.

Unstable angina: trends and characteristics associated with length of hospitalization in the face of diminishing frequency-an evidence of a paradigm shift

Aaqib H Malik  1 , Nauman Siddiqui  2 , Wilbert S Aronow  1
Affiliations

Unstable angina: trends and characteristics associated with length of hospitalization in the face of diminishing frequency-an evidence of a paradigm shift

Aaqib H Malik et al. Ann Transl Med. 2018 Dec.

Abstract

Background: Unstable angina (UA) has been one of the most common presentations of acute coronary syndrome. The numbers of admitted UA patients have been diminishing in the recent past. However, we are seeing higher costs and higher length of inpatient stay. We attempt to identify the trends and characteristics of length of hospitalization in patients admitted with UA using a nationally representative dataset.

Methods: We used the nationwide inpatient sample (NIS) from 2002-2014 to assess the factors associated with length of stay in patients admitted with unstable angina using ICD-9-CM primary diagnosis codes (411.1, 411.81, and 411.89). All variables pertaining to hospitalization were compared across the 3 groups based on varied length of hospital stay.

Results: A total of 131,601 patients were admitted with the diagnosis of UA. The length of inpatient stay was ≤1 day, 2-6 days, and ≥7 days in 60,309 (45.83%), 67,291 (51.13%), and 4,001 (3.05%) patients, respectively. In a multivariate adjusted model, the percentage increased odds of ≥2 days of inpatient stay was noted as follows: age ≥65 years (29%), female gender(24%), African-American race (28%), obesity (14%), diabetes mellitus (15%), chronic lung disease (33%), congestive heart failure (529%), renal failure (26%), coagulopathy (68%), alcohol abuse (21%), peripheral vascular disease (22%), myocardial infarction (17%), deep vein thrombosis (119%), sepsis (105%), pneumonia (171%), stroke (164%), urinary tract infection (112%), blood loss (95%), cardiac catheterization (86%), percutaneous transluminal coronary angioplasty (24%), and blood transfusion (206%). The percentage of UA patients with ≥2 days of hospital stay has decreased from 15% to 3.7%, whereas the average costs of managing a UA patient in the hospital have increased by 175%.

Conclusions: More than half of patients admitted with UA stay in the hospital for ≥2 days, with the most important determinants being pre-existing medical comorbidities and inpatient complications.

Keywords: Unstable angina; acute coronary syndrome (ACS); length of stay.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Mean length of hospital stay in unstable angina patients.
Figure 2
Figure 2
Annual percentage of patients admitted with unstable angina.
Figure 3
Figure 3
Annual mean hospitalization cost of unstable angina patients ($).
Figure 4
Figure 4
Mean hospital charges of unstable angina patients across the length of hospitalization.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lloyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009;119:480-6. 10.1161/CIRCULATIONAHA.108.191259 - DOI - PubMed
    1. Braunwald E, Jones HR, Mark BD, et al. Diagnosing and managing unstable angina. Agency for Health Care Policy and Research. Circulation 1994;90:613-22. 10.1161/01.CIR.90.1.613 - DOI - PubMed
    1. Amsterdam EA, Wenger KN, Brindis GR, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;130:2354-94. 10.1161/CIR.0000000000000133 - DOI - PubMed
    1. Bonello L, Laine M, Puymirat E, et al. Timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes and clinical outcomes: An updated meta-Analysis. JACC Cardiovasc Interv 2016;9:2267-76. 10.1016/j.jcin.2016.09.017 - DOI - PubMed
    1. Elgendy IY, Mahmoud NA, Mansoor H, et al. Early invasive versus initial conservative strategies for women with non-ST-elevation acute coronary syndromes: A nationwide analysis. Am J Med 2017;130:1059-67. 10.1016/j.amjmed.2017.01.049 - DOI - PubMed