Identification of uncomplicated patients with acute myocardial infarction undergoing percutaneous coronary intervention: are these patients suitable for early discharge?
BACKGROUND
The hospital stay after acute myocardial infarction (AMI) is still extremely long in Japan and does not correspond with disease severity. The purpose of the present study was to identify a subgroup of AMI patients suitable for early discharge.


RESULTS
A total of 3,739 AMI patients treated with percutaneous coronary intervention (PCI) within 24 h after onset, who enrolled Osaka Acute Coronary Insufficiency Study between April 1998 and March 2004, were studied. Patients showing no complications within the first 7 days (n=1,786) were considered to be eligible for early discharge. In these patients, multivariate logistic regression analysis selected prior myocardial infarction, left anterior descending coronary artery disease and failed PCI as independent predictors of major complications from day 8 to discharge. Patients without any predictor had significant lower rates of major complications from day 8 to 6 months after discharge than those with 1 or more predictors. Furthermore, in the present study there were no deaths in patients without any predictors.


CONCLUSIONS
Patients who either do not have serious complications during the first 7 days or any predictor are at very low risk of major complications from day 8 to 6 months after discharge. These carefully selected patients may be suitable for early (day 8) hospital discharge after AMI.
Kinjo
Kunihiro
K
Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Japan.
Sato
Hiroshi
H
Sakata
Yasuhiko
Y
Nakatani
Daisaku
D
Mizuno
Hiroya
H
Shimizu
Masahiko
M
Nishino
Masami
M
Matsu-Ura
Yasuhiko
Y
Koretsune
Yukihiro
Y
Nanto
Shinsuke
S
Mishima
Masayoshi
M
Hori
Masatsugu
M
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors