Length of stay in myocardial infarction.
OBJECTIVE
We evaluated the association between length of hospital stay (LOS) and clinical factors, treatment intensity, and use of percutaneous coronary revascularization from 1988 to 1997.


BACKGROUND
Multiple factors contribute to the observed reduction in LOS for patients with myocardial infarction.


METHODS
We studied a series of 849 consecutive patients admitted with acute myocardial infarction to the Mayo Clinic Coronary Care Unit within three time periods: period I (1988-1990), period II (1991-1993), and period III (1994-1997).


RESULTS
Median LOS decreased significantly between 1988 and 1997 (9 days to 5 days, 36% reduction, p < 0.0001), with significant reductions (p < 0.001) associated with certain therapies: primary reperfusion (6 days vs 7 days), b-blockers (6 days vs 8 days), and aspirin (6 days vs 8 days). Hospitalizations were lengthened by coronary artery bypass grafting (12 vs 6 days) and by serious complications (10 vs 6 days). The era of the admission (period I vs II vs III) is a significant, powerful predictor of LOS, even after adjustment for other key variables.


CONCLUSIONS
The 36% reduction in LOS for acute myocardial infarction between 1988 and 1997 is related both to therapeutic modalities and temporal trends. Further study is needed to clarify whether the trend for decreasing LOS persists and influences outcome and health care quality variables.
Sgura
F A
FA
Mayo Clinic, Minn., USA.
Wright
R S
RS
Kopecky
S L
SL
Grill
J P
JP
Reeder
G S
GS
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006770:Hospitals, Group Practice / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*