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. |
