Document Detail


What is the optimal length of stay in hospital for ST elevation myocardial infarction treated with primary percutaneous coronary intervention?
MedLine Citation:
PMID:  21769818     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate the safety and practicality of very early (within 48 h) discharge with long-term follow-up results, and to define an optimal length of stay in hospital for patients with ST elevation myocardial infarction (STEMI) according to their demographic characteristics and risk assessment.
METHODS: A total of 267 patients with STEMI successfully treated with primary coronary intervention were retrospectively analyzed. Patients was divided into four groups according to length of hospitalization: 24 hours, 48 hours, 72 hours, and more than 72 hours. The groups were compared in terms of the patients' demographic and clinical characteristics, short- and long-term follow-up results, mortality, revascularization and major adverse cardiac events (MACE).
RESULTS: More than two thirds of the patients were discharged within 48 hours (68.9%). No difference was observed between groups in terms of one month and one year MACE and one year restenosis. However, one month restenosis was slightly higher in the fourth group. At the end of the first year, there had been only four deaths, and these were in the third and fourth groups. There were no deaths among patients discharged within 48 hours. Killip class, left ventricular ejection fraction, multi-vessel disease and diabetes were the major determinants of length of stay in hospital.
CONCLUSIONS: Very early discharge is safe and feasible and does not increase the mortality rate. Uncomplicated STEMI patients with single vessel disease could be discharged after 24 hours. Patients with multi-vessel disease classified in the low risk group could be discharged after 48 hours.
Authors:
Ahmet Karabulut; Mahmut Cakmak; Bulent Uzunlar; Ahmet Bilici
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  18     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2011  
Date Detail:
Created Date:  2011-07-19     Completed Date:  2011-11-23     Revised Date:  2012-11-09    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  378-84     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Istanbul Medicine Hospital, Hoca Ahmet Yesevi Cad. No. 149, Istanbul, Turkey. drkarabulut@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Balloon, Coronary* / adverse effects,  mortality
Cardiovascular Diseases / etiology
Chi-Square Distribution
Female
Humans
Length of Stay*
Logistic Models
Male
Middle Aged
Myocardial Infarction / mortality,  therapy*
Odds Ratio
Patient Discharge*
Patient Selection
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Turkey

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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