Safety of Early Discharge After Primary Percutaneous Coronary Intervention

Satılmışoğlu, Muhammet Hulusi; Görgülü, Şevket; Aksu, Hale Ünal; Aksu, Hüseyin; Ertaş, Gökhan; Taşbulak, Ömer; Buturak, Ali; Kalkan, Ali Kemal; Değirmencioğlu, Aleks; Köroğlu, Bayram; Tusun, Eyyup; Murat, Ahmet; Öz, Ahmet

doi:10.1016/j.amjcard.2016.03.039

Cited by 15 publications

(24 citation statements)

References 15 publications

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“…No differences in the 30 days health status measurements were registered. In a recent large trial, Satılmısoglu et al 18 randomly assigned 769 probands with STEMI to early (within 48 to 56 h of uneventful course) or standard discharge group. The inclusion criteria were as follows: acute STEMI, a successful primary PCI procedure, an uneventful 24-hour follow-up period, single epicardial artery to be treated.…”

Section: Discussionmentioning

confidence: 99%

Safety of early discharge in low risk patients after acute ST-segment elevation myocardial infarction, treated with primary percutaneous coronary intervention. Open label, randomized trial

Novobílský

Štípal

Černý

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Section: Discussionmentioning

confidence: 99%

Safety of early discharge in low risk patients after acute ST-segment elevation myocardial infarction, treated with primary percutaneous coronary intervention. Open label, randomized trial

Novobílský

Štípal

Černý

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Since the first clinical trial in 1988 which showed the safety and efficacy of early discharge at 3 days for low-risk patients hospitalized with an uncomplicated AMI, 4 a 3 day LOS for patients with an uncomplicated AMI has become increasingly popular in clinical practice. 2,5,10 There are several factors that may have contributed to this trend. For example, the shortened arrival to intervention time inspired by the Door-to-Balloon Alliance for Quality program was associated with a considerably shortened LOS.…”

Section: Discussionmentioning

confidence: 99%

“…This finding confirms results from prior clinical trials in patients treated with a PCI for a STEMI, including the Prague-5 and the Early Discharge after Primary Percutaneous Coronary Intervention (EDAPPCI) trials. 2,19…”

Section: Discussionmentioning

confidence: 99%

“…Prior observational studies and randomized clinical trials have shown that the early (≤72 hours) hospital discharge of patients with an uncomplicated, low risk, AMI is safe and cost-effective. 2–5 However, few studies have examined recent trends in LOS among patients hospitalized with a first uncomplicated AMI, and the impact of early hospital discharge on short-term outcomes in these patients. We examined decade-long (2001–2011) trends in hospital LOS for patients with a first uncomplicated AMI and the impact of early hospital discharge on 30-day hospital readmissions and 30 and 90-day all-cause death rates in these patients.…”

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confidence: 99%

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Trends in Length of Hospital Stay and the Impact on Prognosis of Early Discharge After a First Uncomplicated Acute Myocardial Infarction

Tran

Lessard

Tisminetzky

et al. 2018

The American Journal of Cardiology

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Few studies have examined recent trends in the length of stay (LOS) among patients hospitalized with a first uncomplicated acute myocardial infarction (AMI) and the impact of early hospital discharge on various short-term outcomes in these low-risk patients. We used data from 1,501 residents hospitalized with a first uncomplicated AMI from all central Massachusetts medical centers on a biennial basis between 2001 and 2011. The association between hospital LOS and subsequent hospital readmission or death was examined using logistic regression modeling. The average age of the study population was 63.7 years, 63.0% were men, and 91.4% were non-Hispanic whites. The average hospital LOS declined from 4.1 days in 2001 to 2.9 days in 2011. During the years under study, the average 30-day hospital readmission rate was 11.9%, whereas the 30- and 90-day death rates were 1.5% and 2.9%, respectively. The multivariable adjusted odds ratio of a 30-day hospital readmission (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.52 to 1.41), or 30-day (OR = 0.93, 95% CI = 0.29 to 2.98) and 90-day (OR = 0.89, 95% CI = 0.36 to 2.20) death rates were not significantly different between patients who were discharged from central Massachusetts medical centers during the first 2 days as compared with those discharged thereafter. In conclusion, the average LOS in patients with a first uncomplicated AMI declined during the years under study, and early discharge from the hospital at day 2 or sooner of these low-risk patients does not appear to be associated with an increased risk of adverse events post discharge compared with those discharged at a later time.

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“…Neither all-cause mortality nor readmissions were different between the early discharge (48-56 hours) and standard discharge groups ( p = 0.684 and p = 0.061, respectively) post primary PCI. Quality-of-life measures were also not statistically different between the two study group [25]. Early discharge using CADILLAC risk score showed lower mortality at day three or later in patients with lower risk score post PCI in STEMI [26].…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Ejection Fraction along with Zwolle Risk Score for Risk Stratification to Enhance Safe and Early Discharge in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention: A Retrospective Observational Study

Banga

Gumm

Kizhakekuttu

et al. 2019

Cureus

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IntroductionZwolle risk score (ZRS) is a validated scoring system to determine the time of discharge in ST-segment elevation myocardial infarction (STEMI) patients. Left ventricular ejection fraction (LVEF) also provides prognostic information after ST-elevation myocardial infarction (STEMI). We studied that the addition of LVEF to ZRS variable can improve decision making in safe and early discharge in STEMI patients post-primary coronary intervention.MethodsOverall, 249 STEMI patients were studied retrospectively. LVEF was considered as an independent variable. The patients having LVEF <50% were under Group A and LVEF ≥50% were under Group B. Groups were analyzed by model comparison for overall hospital length of stay (LOS) and Intensive care unit (ICU) LOS post-primary percutaneous coronary intervention (PCI).ResultsThere were 123 patients in Group A and 126 patients in Group B. Comparison for primary outcomes showed significant difference with hospital length of stay (LOS) being 3.1 ± 2.3 days in Group A versus 2.1 ± 0.8 days in Group B (p < 0.001). Similarly, ICU stay was also significantly higher in Group A with 36.5 ± 31.4 hours versus 24.0 ± 11.8 hours for Group B, which led to prolonged hospitalization for patients with LVEF <50%. Model 1 that considers ZRS individually is nested within Model 2 where ZRS and LVEF are considered together. The profile log-likelihood ratio test favors model 2 over model 1 (p < 0.0001). Similarly for ICU LOS, R2 = 0.12 (Model 1) < R2 = 0.20 (Model 2). The F test favors model 2 over model 1 (p < 0.0001).ConclusionWe concluded that adding LVEF to Zwolle risk score gives a better model for risk stratification in STEMI patients to decide early and safe discharge post-primary PCI.

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Safety of Early Discharge After Primary Percutaneous Coronary Intervention

Cited by 15 publications

References 15 publications

Safety of early discharge in low risk patients after acute ST-segment elevation myocardial infarction, treated with primary percutaneous coronary intervention. Open label, randomized trial

Safety of early discharge in low risk patients after acute ST-segment elevation myocardial infarction, treated with primary percutaneous coronary intervention. Open label, randomized trial

Trends in Length of Hospital Stay and the Impact on Prognosis of Early Discharge After a First Uncomplicated Acute Myocardial Infarction

Left Ventricular Ejection Fraction along with Zwolle Risk Score for Risk Stratification to Enhance Safe and Early Discharge in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention: A Retrospective Observational Study

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