title: Predictors of hospital length of stay in heart failure: findings from Get With the Guidelines.
abstract: BACKGROUND
  This study was undertaken to identify predictors of hospital length of stay (LOS) for heart failure (HF) patients using clinical variables available at the time of admission and hospital characteristics.
  
  
  RESULTS
  A cohort of 70,094 HF patients discharged to home from 246 hospitals participating in the Get With the Guidelines-Heart Failure was analyzed for admission predictors for LOS. The analysis incorporated patient characteristics (PC) first, then added hospital characteristics (HC) followed by standard laboratory evaluations (SL), including troponin and brain natriuretic peptide (BNP). There were 31,995 patients (45.6%) with LOS < 4 days, 26,750 (38.2%) with LOS 4 to 7 days, and 11,349 (16.2%) with LOS > 7 days. Patients with longer LOS had more comorbidities and a higher severity of disease on admission. Overall models explained a modest amount of LOS variation, with an r(2) of 4.8%, with PC responsible for 1.3% of variation and together with SL explained 2.2% of variation. HC did not change the variation.
  
  
  CONCLUSIONS
  Based on admission vital signs and BNP levels, patients with longer LOS have more comorbidities and a higher disease severity. The ability to risk stratify for LOS based on patient admission and hospital characteristics is limited.
authors.affiliation: Jefferson Medical College, Philadelphia, PA 19107, USA. david.whellan@jefferson.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Whellan
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.forename: Li
authors.initials: L
authors.lastname: Liang
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: Paul A
authors.initials: PA
authors.lastname: Heidenreich
authors.forename: Lee H
authors.initials: LH
authors.lastname: Schwamm
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards*; D011237:Predictive Value of Tests; D011446:Prospective Studies