Why the study?
Can criteria based on the first four hospital days predict late urgent complications and identify acute myocardial infarction patients suitable for early discharge?
Can criteria based on the first four hospital days predict late urgent complications and identify acute myocardial infarction patients suitable for early discharge?
Patients with acute myocardial infarction who experience no complications in the first four hospital days are at very low risk for subsequent urgent complications, making early discharge feasible.
May support early discharge in low-risk AMI after four uncomplicated days; extends prior criteria but observational data leave practice change premature.
All patients admitted to a community hospital coronary care unit during an 18-month-period were studied to validate previously reported criteria for early hospital discharge after myocardial infarction. Factors present during the first four hospital days, which predict subsequent complications requiring urgent medical attention, were classified as either urgent or prognostic. Patients whose initial four days were marked by either no complications (81 patients) or prognostic complications (51 patients) are described. Only one patient in the group of 81 patients had a subsequent urgent complication. Four of 55 patients had late urgent complications. Persistent sinus tachycardia occurred during the first four days in all four of these 55 patients. Early hospital discharge would be feasible in the group with neither urgent nor prognostic complications. Further study of persistent sinus tachycardia is required to improve its predictive ability.
No takes yet. Share an insight, caveat, or question.
Harry W. Severance (1982) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: