Clinical and Functional Predictors of Prolonged Hospitalization in STEMI Patients Following Percutaneous Coronary Intervention
Clinical and Functional Predictors of Prolonged Hospitalization in STEMI Patients Following Percutaneous Coronary Intervention
Author(s):Aroonsri Sanmuang, Montri Yasud, Montana Donsom, Hathaichanok Makphin, Sahachat Aueyingsak, Chamnian Pattanajak
Received: April 28, 2026
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Accepted: May 20, 2026
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Published:
June 3, 2026
Abstract
Background: ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) typically require 3 to 5 days of hospitalization. Prolonged length of stay (LOS) significantly impacts healthcare quality, family burden, and resource allocation. This study aimed to identify clinical predictors and explore the effect of pre-discharge functional capacity on prolonged hospitalization in STEMI-PCI patients in Thailand.
Methods: A retrospective observational cohort study was conducted using the Acute Coronary Syndrome registry at the Queen Sirikit Heart Center (June 2021–June 2023). The analysis included 536 STEMI-PCI survivors, categorized into standard LOS (≤ 5 days; n = 379) and prolonged LOS (> 5 days; n = 157) groups. Independent predictors were determined using multiple logistic regression.
Results: The prolonged LOS cohort was significantly older, had a higher proportion of females, presented with greater clinical severity, and experienced more in-hospital complications. Following multivariate adjustment, initial Killip class IV emerged as the strongest independent predictor of prolonged hospitalization (Adjusted OR = 4.73; 95% CI: 2.56–8.74, p < 0.001). Mechanical complications demonstrated a borderline trend for extended stays (p = 0.053). Conversely, higher physical activity capacity, as indicated by higher estimated pre-discharge METs, was significantly associated with a shorter duration of hospitalization.
Conclusion: Initial hemodynamic compromise, notably Killip class IV, is the primary driver of prolonged hospitalization in STEMI patients following PCI. Higher pre-discharge functional capacity correlates with shorter stays, underscoring the vital role of cardiopulmonary reserve and early rehabilitation strategies in optimizing patient recovery.
Methods: A retrospective observational cohort study was conducted using the Acute Coronary Syndrome registry at the Queen Sirikit Heart Center (June 2021–June 2023). The analysis included 536 STEMI-PCI survivors, categorized into standard LOS (≤ 5 days; n = 379) and prolonged LOS (> 5 days; n = 157) groups. Independent predictors were determined using multiple logistic regression.
Results: The prolonged LOS cohort was significantly older, had a higher proportion of females, presented with greater clinical severity, and experienced more in-hospital complications. Following multivariate adjustment, initial Killip class IV emerged as the strongest independent predictor of prolonged hospitalization (Adjusted OR = 4.73; 95% CI: 2.56–8.74, p < 0.001). Mechanical complications demonstrated a borderline trend for extended stays (p = 0.053). Conversely, higher physical activity capacity, as indicated by higher estimated pre-discharge METs, was significantly associated with a shorter duration of hospitalization.
Conclusion: Initial hemodynamic compromise, notably Killip class IV, is the primary driver of prolonged hospitalization in STEMI patients following PCI. Higher pre-discharge functional capacity correlates with shorter stays, underscoring the vital role of cardiopulmonary reserve and early rehabilitation strategies in optimizing patient recovery.
Keywords: STEMI; percutaneous coronary intervention; length of stay; Killip class; functional capacity, Role of Cath Lab and CCU Nursing
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