Duration of Hospital Stay and Post- Myocardial Infarction Morbidity and Mortality: A Kaiser-Permanente Experience

Abstract

Among 209 evaluable consecutive patients (mean age 57 years) admitted in 1978 and 1979 for acute myocardial infarction, 186 survived. The mean hospital stay of the survivors was 9.7 days. Of these patients, 99 (53%) with complicated myocardial infarction had a mean hospital stay of 11.2 days; 87 (47%) with uncomplicated infarction had a mean stay of 7.9 days. All patients were followed for at least 6 months. During the 6-month post-hospitalization interval, the overall mortality was about 6%. Of the 12 patients who died, 11 had complicated, and 1 had uncomplicated myocardial infarction. The reinfarction rate in 6 months was 4% for complicated and 2% for uncomplicated infarction. Congestive heart failure was 3% for complicated and zero for uncomplicated infarction. Comparing these findings with reported series of patients with longer hospitalizations, we found no evidence that shortened hospitalization adversely affects mortality or morbidity.

Serious Infection After Acute Myocardial Infarction

“…Whereas the length of stay after uncomplicated STEMI in the United States is approximately 4-5 days, length of stay in complicated STEMI has been shown to average 11 days (36,37). In our study, we demonstrated that patients with clinically diagnosed serious infections had longer length of stay than patients without infections, mirroring previous data on uncomplicated and complicated MIs.…”

The length of hospitalization after acute myocardial infarction determined by risk calculation.

“…The earliest proposed discharge-day was day 3,13 but in most studies the patients selected for early discharge could often leave the hospital at day 7,16 8,'14 17, 20,45 9,15 or 10.18 21,41,46,47 This is slightly later than proposed in this study.…”