ArticleBMC cardiovascular disorders2026
The impact of the Elixhauser comorbidity index on length of stay in patients with coronary artery disease.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo investigate the association between the modified Elixhauser Comorbidity Index (ECI) and length of stay (LOS) among patients with coronary artery disease (CAD).
methodsA retrospective study was conducted using hospitalization data from the Hubei Provincial Traditional Chinese Medicine Comprehensive Statistics Platform between December 2013 and June 2024. Comorbidity burden was assessed using the modified ECI. Univariate analysis and multivariable Gamma regression models with a log-link function were performed to identify factors independently associated with LOS. Sensitivity analyses were conducted to evaluate the robustness of the findings.
resultsAmong 22,626 CAD patients with a median LOS of 9 (6-13) days, ECI remained independently associated with LOS after adjustment for demographic and clinical covariates. Compared with ECI ≤ 0, patients with ECI 1-3 had 10.0% longer LOS (Exp(B) = 1.100, 95% CI = 1.064-1.138, p < 0.001), and those with ECI 4-8 had 2.9% longer LOS (Exp(B) = 1.029, 95% CI = 1.003-1.055, p = 0.026). The ECI ≥ 9 group was not statistically significant in the primary analysis but became significant after excluding patients with extremely prolonged LOS (p = 0.027). A paradoxical pattern was observed, with greater LOS prolongation in patients with mild rather than moderate-to-high comorbidity burden.
conclusionECI was independently associated with LOS in CAD patients. The non-linear association between comorbidity burden and LOS suggests a more complex relationship than a simple dose-response pattern, which may have implications for risk stratification and individualized inpatient management in CAD populations.
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