Why the study?
What are the predictors of prolonged hospital stay after primary PCI for STEMI, and does prolonged stay affect 1-year mortality?
What are the predictors of prolonged hospital stay after primary PCI for STEMI, and does prolonged stay affect 1-year mortality?
Prolonged hospital stay after primary PCI for STEMI is predicted by factors such as low LVEF, older age, and heart failure on admission, but is not significantly associated with increased 1-year mortality.
Low-LVEF patients may need longer post-STEMI PCI stays without raising 1-year mortality; leaves open tailored discharge timing in observational data.
OBJECTIVE: Although most patients with ST-elevation myocardial infarction treated by primary percutaneous coronary intervention (PCI) have a good prognosis and can be discharged from hospital very soon, some patients must be admitted longer. We performed the current analysis to assess predictors and the prognostic significance of prolonged hospital stay. PATIENTS AND METHODS: In this prospective observational study, individual data from 2323 patients who survived at least 2 days after primary PCI in our hospital were recorded. Patients in the highest tertile of hospital stay were compared with the other patients. Both predictors and prognostic importance of prolonged hospital stay were evaluated. RESULTS: Mean admission duration was 6.7 days (standard deviation=6.6). A total of 797 patients had a hospital stay for more than 6 days (highest tertile). Patients with a longer hospital stay were older, more often female, had more often a history of previous myocardial infarction and signs of heart failure on admission, and had more frequently Thrombolysis in Myocardial Infarction flow 0 before PCI. In addition, a low left ventricular ejection fraction was independently associated with prolonged hospital stay [odds ratio: 2.06 (95% confidence interval: 1.54-2.76)], but with a comparable risk of 1-year mortality [odds ratio: 1.3 (95% confidence interval: 0.8-2.0)]. CONCLUSION: According to this study, a low left ventricular ejection fraction is associated with prolonged hospital stay in patients after primary PCI. Predictors of prolonged hospital stay are age, female sex, previous myocardial infarction, heart failure on admission, and Thrombolysis in Myocardial Infarction flow 0 before PCI.
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Schellings et al. (2011) studied this question.
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