What is the clinical evidence from this study?

Study design: Observational. Population: Acute Myocardial Infarction (n=4113). Intervention: Observational (Predictors of hospital stay). Primary outcome: Mean length of hospital stay.

What does this research mean for the field?

The mean length of hospital stay after acute myocardial infarction in Japan is 31.2 days, with clinical factors explaining only 26% of the variation in stay duration. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2004Open Access

Predictors of Length of Hospital Stay After Acute Myocardial Infarction in Japan

KKKunihiro KinjoThe University of Osaka HSHiroshi SatoGeneral / Preventive / Lipids DNDaisaku NakataniOsaka Gakuin University

Key Result

The mean length of hospital stay after acute myocardial infarction in Japan was 31.2 days, with clinical factors explaining only 26% of the variation.

Study Design

Type

Observational (n=4,113)

Multicenter

Yes

Structured PICO

Population

4,113 surviving acute myocardial infarction (AMI) patients enrolled in the Osaka Acute Coronary Insufficiency Study from April 1998 to March 2003 in Japan.

Outcome

Length of hospital stay

The length of hospital stay for acute myocardial infarction in Japan is exceptionally long (mean 31.2 days) and is largely driven by non-clinical factors such as occupational status and hospital volume.

Limitations

The study population from the Osaka region may not reflect the characteristics of the entire Japanese population.
Nearly 68% of the variation in hospital stay remains unexplained by the data.
The observational design cannot rule out the possibility of confounding by unmeasured variables such as socioeconomic status or social support.

Abstract

BACKGROUND: In Western countries, the length of hospital stay after acute myocardial infarction (AMI) has decreased dramatically during the past 3 decades and is now approximately 1 week. However, epidemiological data concerning the length of hospital stay, its predictors and trends based on a large-scale sample are still limited in Japan. METHODS AND RESULTS: The study group comprised 4,113 surviving AMI patients who were enrolled in the Osaka Acute Coronary Insufficiency Study from April 1998 to March 2003. The mean length of hospital stay was 31.2 days. Clinical factors (patient characteristics, severity of infarction, therapy, and in-hospital complications) only explained 26% of the variation in hospital stay. The mean hospital stay was significantly longer in 1998 than in 2002. In 2002, occupational status and admission to a high-volume hospital were independent predictors of a shorter hospital stay, but this association was not observed in 1998. CONCLUSIONS: The hospital stay is still extremely long in Japan and clinical factors do not provide an explanation. The findings of the present study suggest that the hospital stay could be reduced in some patients with AMI, but randomized studies are needed to examine the feasibility of early discharge.

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