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Objectives <p>To investigate the association between the modified Elixhauser Comorbidity Index (ECI) and length of stay (LOS) among patients with coronary artery disease (CAD).</p> Methods <p>A 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.</p> Results <p>Among 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, <i>p</i> &lt; 0.001), and those with ECI 4–8 had 2.9% longer LOS (Exp(B) = 1.029, 95% CI = 1.003–1.055, <i>p</i> = 0.026). The ECI ≥ 9 group was not statistically significant in the primary analysis but became significant after excluding patients with extremely prolonged LOS (<i>p</i> = 0.027). A paradoxical pattern was observed, with greater LOS prolongation in patients with mild rather than moderate-to-high comorbidity burden.</p> Conclusion <p>ECI 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.</p>

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The impact of the Elixhauser comorbidity index on length of stay in patients with coronary artery disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • Wenting Yan,
  • Shuanggui Tian,
  • Yong Xiao,
  • Guodong Xu

摘要

Objectives

To investigate the association between the modified Elixhauser Comorbidity Index (ECI) and length of stay (LOS) among patients with coronary artery disease (CAD).

Methods

A 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.

Results

Among 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.

Conclusion

ECI 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.