title: [Mean length of stay and prognosis in unstable angina. Results from the ARIAM database].
abstract: OBJECTIVE
  The objective of this project is to investigate the factors predicting mortality and mean length of stay in patients diagnosed with unstable angina (UA) during admission to the Intensive Care Unit or Critical Care Unit (ICU/CCU).
  
  
  METHODS
  A retrospective cohort study including all the UA patients listed in the Spanish ARIAM register. The study period comprised from June, 1996 to December, 2003. The follow-up period is limited to the stay in the ICU/CCU. One univariate analysis was performed between deceased and live patients; and another between prolonged and non-prolonged stay patients. Three multivariate analyses were also performed; one to evaluate the factors related to mortality, another to evaluate the variables associated to percutaneous coronary intervention (PCI) and another to evaluate the factors associated to the prolonged mean stay in ICU/CCU.
  
  
  RESULTS
  14,096 patients with UA were included in the study. The UA mortality rate during ICU/CCU admission was 1.1%. Mortality was associated to Killip classification, age, the need for CPR, development of cardiogenic shock, development of arrhythmia (such as VF, sinus tachycardia or high-degree atrioventricular block) and diabetes; whereas patients who smoke were associated to a lower mortality rate. PCI was only performed in 1,226 patients (8.9%), increasing over the years. The PCI-predicting variables were: age, being referred from another hospital, smoking, presenting prior acute myocardial infarction (AMI), complications consisting of cardiogenic shock or high-degree atrioventricular block and being treated with oral beta blockers. The mean length of stay in ICU/CCU was 3.15 (18.65) days (median, 2 days), depending on age, a coronariography having previously been performed, the Killip classification, having required coronariography and PCI or echocardiography or mechanical ventilation, and presenting complications such as angina that is difficult to control, arrhythmia, right ventricular failure or death.
  
  
  CONCLUSIONS
  The factors are associated to mortality were; greater age, diabetes, Killip classification, arrhythmia, cardiogenic shock and the need for CPR, whereas smoking is associated to a lower mortality rate. The patients on whom PCI was performed represent a less severe population. Management has changed over the years, with an increase in PCI. A prolonged mean length of stay is associated to the appearance of arrhythmia, right or left heart failure, angina that is difficult to control, age and PCI.
authors.affiliation: Unidad de Cuidados Intensivos, Servicio de Cuidados Críticos y Urgencias, Hospital Universitario Médico-Quirúrgico, Complejo Hospitalario, Jaén, España. mrb1604@terra.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruiz-Bailén
authors.forename: Inés
authors.initials: I
authors.lastname: Macías-Guaras
authors.forename: Luis
authors.initials: L
authors.lastname: Rucabado-Aguilar
authors.forename: Juan Miguel
authors.initials: JM
authors.lastname: Torres-Ruiz
authors.forename: Ana María
authors.initials: AM
authors.lastname: Castillo-Rivera
authors.forename: Antonio
authors.initials: A
authors.lastname: Pintor Mármol
authors.forename: Manuela
authors.initials: M
authors.lastname: Expósito Ruiz
authors.forename: José
authors.initials: J
authors.lastname: Benitez-Parejo
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Rodríguez-García
authors.forename: José Angel
authors.initials: JA
authors.lastname: Ramos-Cuadra
authors.forename: Angel
authors.initials: A
authors.lastname: García-Alcántara
authors.forename: Javier
authors.initials: J
authors.lastname: Macías-Guarasa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D002423:Cause of Death; D017023:Coronary Angiography; D003325:Coronary Care Units / Q000706:statistics & numerical data; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology