Abstract 20198: Length of Stay and 30 Day Mortality in Patients Suffering an Uncomplicated ST-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention in New York State
Introduction: Little is known about the most appropriate duration of hospitalization in patients suffering an STEMI treated with primary PCI.
Methods: We reviewed the prospective New York State (NYS) Department of Health PCI database and identified all patients admitted with STEMI between 2007-2009. Patients with no complications (stroke, heart failure, ejection fraction <40%, malignant ventricular arrhythmia, abrupt closure or the treatment site or major side branch, vascular complication requiring intervention, renal failure, cardiac surgery, stent thrombosis, repeat PCI, and coronary perforation) from the onset of infarction throughout the hospitalization were identified. Patients who were discharged after 2 nights vs 3 nights in the hospital were analyzed and compared. Clinical, angiographic and procedural characteristics; and 30 days outcomes, were compared for the 2 groups.
Results: During the study period, 13,399 patients were admitted with STEMI in NYS; 4,939 patients (36.9%) did not develop or meet any exclusion criteria. Of these patients, 1,818 patients (36.8%) were discharged after 2 nights in the hospital, and 1,922 patients (38.9%) were discharged after 3 nights. The remaining 1,199 patients (24.3%) were discharged after 4 or more nights, and were not analyzed further. Patients discharged after 2 nights were more likely to be male, white, have a higher ejection fraction, and less likely to have multi-vessel disease than patients discharged after 3 nights (P<0.05 for all comparisons). Death in the 24 hours after discharge occurred in none of the patients discharged after 2 nights, and 2 patients (0.1%) discharged after 3 nights. There was no difference in 30-day mortality rates between patients discharged after 2 nights (n=4, 0.22%) versus after 3 nights (n=3, 0.16%).
Conclusions: The duration of hospitalization among apparently uncomplicated STEMI patients varies considerably. Among patients discharged after 2 nights in the hospital, mortality in the following day is very low (4 of 1,818 patients in the current study). Mortality at 30 days among such patients is also very low, and similar to that of patients discharged after 3 nights in the hospital.
Author Disclosures: G. Yost: None. E.L. Hannan: None. Y. Zhong: None. P.B. Berger: None.
- © 2014 by American Heart Association, Inc.