Why the study?
Given high demand as the sole regional tertiary cardiac center, the authors aimed to assess the feasibility and safety of early discharge in a selected proportion of AMI patients.
Does early discharge (within 24-72 hours) maintain safety and prevent readmissions in low-risk AMI patients treated with PCI?
Does early discharge (within 24-72 hours) maintain safety and prevent readmissions in low-risk AMI patients treated with PCI?
Early discharge within 24-72 hours for low-risk AMI patients treated with PCI appears safe and feasible, potentially reducing hospital burden during high-demand periods.
Early discharge may be feasible in selected low-risk AMI post-PCI; hypothesis-generating and requires RCTs before practice change.
BACKGROUND: Shortening of the hospital stay in patients admitted with the diagnosis of acute myocardial infarction (AMI) has been observed within the last decades. Our center is the only cardiac center in the region providing tertiary care facility and hence receives all AMI patients deemed suitable for invasive assessment and management and this leads to huge required demand. Our aim is to assess feasibility and safety of the early discharge of selected proportion of AMI patients. RESULT: Out of 557 of patients presented with AMI and treated with percutaneous coronary intervention (PCI), 310 (56%) were discharged early. Men patients and pilgrims were more prevalent among the early discharge group. Early discharged patients had significantly less comorbidities compared to the other group of patients. Moreover, they presented mainly with ST-elevation myocardial infarction (P = 0.04) and treated more with primary percutaneous coronary intervention (PPCI) (P = 0.04). They had favorable coronary anatomy (P = 0.01 and 0.02 for left main and multi-vessel coronary artery disease, respectively), better hospital course, and higher left ventricular ejection fraction compared to non-early discharged patients (P = 0.006 and < 0.001 for pulmonary edema and left ventricular ejection fraction post myocardial infarction). Follow-up of those early discharged patients were promising as majority of them were asymptomatic (95%) and did well post-discharge. CONCLUSION: Our study demonstrated data that support safety of early discharge in a carefully selected group of AMI patients. Early but safe discharge may have a huge impact on increasing bed availability, reducing hospital costs, and improving patient's satisfaction.
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Khaled et al. (2020) studied this question.
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