The Feasibility and Safety of Early Discharge for Low Risk Patients with Acute Myocardial Infarction after Successful Direct Percutaneous Coronary Intervention.

Yip, Hon‐Kan; Wu, Chiung‐Jen; Chang, Hsueh-When; Hang, Chi‐Ling; Wang, Chao-Ping; Yang, Cheng‐Hsu; Hung, Wei‐Chin; Yu, Ten-Hung; Yeh, Kuo-Ho; Chua, Sarah; Fu, Morgan; Chen, Mien‐Cheng

doi:10.1536/jhj.44.41

Cited by 12 publications

(14 citation statements)

References 22 publications

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“…2,3,4,9) There was no study in which the average time of hospitalization was less than 72 hours. The majority of these studies dealt with patients treated with intravenous thrombolysis, 2,4) and most investigated patients who underwent coronary angiography or exercise testing before discharge from the hospital.…”

Section: Discussionmentioning

confidence: 99%

Next Day Discharge After Successful Primary Angioplasty for Acute ST Elevation Myocardial Infarction An Open Randomized Study "Prague-5"

et al. 2008

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SUMMARYThis study tested the feasibility and safety of next day hospital discharge after successful primary PCI for uncomplicated STEMI. Twenty-three p-PCI patients (out of 271 consecutive patients) who fulfilled the study inclusion criteria were enrolled in the pilot nonrandomized phase (transfer of patients from the coronary unit to a standard ward within 24 hours after their admission) of the study. The randomized phase of the study screened a total of 1946 consecutive STEMI patients undergoing p-PCI in the two participating centers. Only 56 (ie, 2.9% from all p-PCI) very low risk patients residing less than 20 km from the PCI center were selected. They were randomized 1:2 to either a standard hospital stay (group A, n = 19, age, 58 ± 8) or first day discharge (group B, n = 37, age, 56 ± 10; NS). There were no serious complications among 79 study patients within 30 days. The duration of hospital stay was 105 ± 45 hours (group A) and 29 ± 3 hours (P < 0.0001) in group B. Ejection fraction after 30 days was 56.8 ± 6.5% in group A versus 57.3 ± 7% in group B (NS). A patient comfort questionnaire showed a clear preference of first day discharge in all patients randomized into group B.The results indicate that next day discharge after successful p-PCI is feasible and safe in selected uncomplicated STEMI patients. (Int Heart J 2008; 49: 653-659)

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Section: Discussionmentioning

confidence: 99%

Next Day Discharge After Successful Primary Angioplasty for Acute ST Elevation Myocardial Infarction An Open Randomized Study "Prague-5"

et al. 2008

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“…Three articles presenting information about returning to work (6,10,16) , showed that patients who had early mobilization returned earlier to their jobs (12 weeks in average) when compared to those who had late Chart 3 -Studies comparing early and late hospital discharge after acute myocardial infarction (20) 1973 69 69 14 th day 21 st day Ahlmark (22) 1979 128 124 8 th day 15 th day Baughman (21) 1982 64 59 14 th day 21 st day Cheng (23) 1986 34 34 5 th day 10 th day Yip (25) 2003 266 197 <4 days >4 days Barchielli (24) 2007 115 327 3 rd and 4 th day 9 th day Chart 4 -Complications after patients with acute myocardial infarction were discharged from the hospital, articles describing them and the number of patients who had presented them again, according to early and late hospital discharge.…”

Section: Early and Late Mobilizationmentioning

confidence: 99%

“…Re-infarction Hutter (20) ; Baughman (21) Ahlmark (22) , Cheng (23) , Barchielli (24) , Yip (25) 61 (5.18%) 34 (5.51%) Angina Hutter (20) ; Baughman (21) Ahlmark (22) Cheng (23) , Yip (25) 33 (5.88%) 42 (8.64%)…”

Section: Complications Articles Describing the Complication N And % Omentioning

confidence: 99%

“…Cardiac Failure Hutter (20) Ahlmark (22) 10 (4.33%) 6 (2.64%) Arrhythmia Ahlmark (22) 1 (0.78%) 1 (0.81%) Revascularization Barchielli (24) , Yip (25) 118 (13.36%) 16 (4.83%) Renal Failure Yip (25) 1 (0.37%) 0 (0%) Pneumonia Yip (25) 0 (0%) 1 (0.51%) Gastric Bleeding Yip (25) 0 (0%) 1 (0.37%) Pseudoaneurysm Yip (25) 1 (0.37%) 0 (0%) mobilization (15 weeks in average). Five articles analyzed (6,10,12,15,18) compared mobilization and hospital discharge, showing that the early mobilization group stayed in the hospital for 16.2 days in average, and the average period for the late mobilization group was 20.9 days.…”

Section: Complications Articles Describing the Complication N And % Omentioning

confidence: 99%

“…Early and late hospital discharge Among 18 selected articles, 7 were related to early and late hospital discharge (19)(20)(21)(22)(23)(24)(25) with 2090 patients; 1379 patients had early hospital discharge and 711 had late hospital discharge.…”

Section: Complications Articles Describing the Complication N And % Omentioning

confidence: 99%

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Mobilization and early hospital discharge for patients with acute myocardial infarction: literature review

et al. 2008

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Objective: This study was a literature review with the purpose of analyzing articles comparing early and late mobilization and those comparing early and late discharge for patients with acute myocardial infarction. Methods: The literature review was performed using the Lilacs and Medline databases , and the length of the resting period, the hospitalization and possible complications were analyzed. Results: We selected 18 articles; 11 of them compared early and late mobilization and 7 compared early and late discharge. The length of the resting period in the early mobilization group varied from 2 to 10 days and 5 to 28 days for the longest resting period. The early discharge group stayed in the hospital from 3 to 14 days and the late discharge group stayed in the hospital from 5 to 21 days. Conclusion:The studies show that there is no evidence of complications related to short periods of bed rest and hospitalization. Keywords: Myocardial infarction; Early ambulation; Patient discharge RESUMO Objetivo: Analisar os artigos que comparavam a mobilização precoce com a tardia, bem como aqueles que comparavam a alta precoce com a tardia em pacientes com infarto agudo do miocárdio. Métodos: A revisão bibliográfica foi realizado nas Bases de Dados Lilacs e Medline, e foram analisados o tempo de repouso e de hospitalização e as complicações observadas nos estudos. Resultados: Foram selecionados 18 artigos, divulgados entre 1996 e 2007, sendo que 11 comparavam a mobilização precoce com a tardia e 7 a alta precoce com a tardia. O período de repouso no leito para mobilização precoce variou de 2 a 10 dias e de 5 a 28 dias para mobilização tardia. Com relação ao tempo de hospitalização observou-se que o período de alta precoce variou de 3 a 14 dias e de 5 a 21 dias para alta tardia. Conclusão: Os estudos mostram que não há evidências de maiores complicações relacionadas a curtos períodos de repouso e de hospitalização. Descritores: Infarto do miocárdio; Ambulação precoce; Alta do paciente RESUMEN Objetivo: Analizar los artículos que comparaban la movilización precoz con la tardía, así como aquellos que comparaban el alta precoz con la tardía en pacientes con infarto agudo del miocardio. Métodos: La revisión bibliográfica fue realizada en las Bases de Datos Lilacs y Medline, y fueron analizados el tiempo de reposo y de hospitalización y las complicaciones observadas en los estudios. Resultados: Fueron seleccionados 18 artículos, difundidos entre 1996 y 2007, de los cuales 11 comparaban la movilización precoz con la tardía y 7 el alta precoz con la tardía. El período de reposo en la cama para la movilización precoz varió de 2 a 10 días y de 5 a 28 días para la movilización tardía. Con relación al tiempo de hospitalización se observó que el período de alta precoz varió de 3 a 14 días y de 5 a 21 días para el alta tardía. Conclusión: Los estudios muestran que no hay evidencias de mayores complicaciones relacionadas a los cortos períodos de reposo y de hospitalización. Descriptores: Infarto del miocardio; Deambulación precoz...

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Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions

Seto

Shroff

Abu‐Fadel

et al. 2018

Cathet Cardio Intervent

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Since the publication of the 2009 SCAI Expert Consensus Document on Length of Stay Following percutaneous coronary intervention (PCI), advances in vascular access techniques, stent technology, and antiplatelet pharmacology have facilitated changes in discharge patterns following PCI. Additional clinical studies have demonstrated the safety of early and same day discharge in selected patients with uncomplicated PCI, while reimbursement policies have discouraged unnecessary hospitalization. This consensus update: (1) clarifies clinical and reimbursement definitions of discharge strategies, (2) reviews the technological advances and literature supporting reduced hospitalization duration and risk assessment, and (3) describes changes to the consensus recommendations on length of stay following PCI (Supporting Information Table S1). These recommendations are intended to support reasonable clinical decision making regarding postprocedure length of stay for a broad spectrum of patients undergoing PCI, rather than prescribing a specific period of observation for individual patients.

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The Feasibility and Safety of Early Discharge for Low Risk Patients with Acute Myocardial Infarction after Successful Direct Percutaneous Coronary Intervention.

Cited by 12 publications

References 22 publications

Next Day Discharge After Successful Primary Angioplasty for Acute ST Elevation Myocardial Infarction An Open Randomized Study "Prague-5"

Next Day Discharge After Successful Primary Angioplasty for Acute ST Elevation Myocardial Infarction An Open Randomized Study "Prague-5"

Mobilization and early hospital discharge for patients with acute myocardial infarction: literature review

Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions

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