Short hospital stay for AMI not linked to adverse outcomes
MedWire News: Short hospital stay among patients admitted with acute myocardial infarction (AMI) is not associated with increased readmission or mortality risk, a US study indicates.
Jane Saczynski (University of Massachusetts Medical School, Worcester, USA) and team say: "We found that shorter length of hospital stay (LOS) did not adversely affect the risk of hospital readmission 7 and 30 days after hospital discharge or mortality in the 30 and 90 days following discharge."
The study of 4184 AMI patients in New England, reported in the American Journal of Medicine, showed that over a 10-year period, the median LOS declined by 30%, from 7.2 days in 1995 to 5.0 days in 2005 (p<0.001). Further investigation by Saczynski and team revealed that a long LOS adversely affected post-discharge mortality risk. Patients with a long LOS (≥10 days) had 2.38- and 2.53-fold higher risks for 30- and 90-day post-discharge mortality, respectively, than those with a median LOS (5-6.9 days).
However, patients with a short LOS (<5 days) had similar 30- and 90-day post-discharge mortality risks as those with a median LOS.
Although the researchers were unable to collect complete rehospitalization data for the entire study period, logistic regression was used to estimate readmission rates over the 10-year period.
After adjustment for multiple confounding variables, such as age and gender, patients with a short LOS had a 28% higher risk for rehospitalization at 7 days than those with a long LOS, whereas at 30 days their rehospitalization risk was 6% lower. However, neither difference was statistically significant.
Given the lack of adverse outcomes associated with early discharge, the researchers suggest it may be worthwhile to devise new ways to classify patients at low risk for poor outcomes in order to identify those "who may benefit from early hospital discharge."
They conclude: "Further studies are needed to identify the optimal LOS for patients who have experienced an AMI."
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By Lauretta Ihonor