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Discharge timing and outcomes after uncomplicated non-ST-segment elevation acute myocardial infarction.

Publication ,  Journal Article
Rymer, JA; Tempelhof, MW; Clare, RM; Pieper, KS; Granger, CB; Van de Werf, F; Moliterno, DJ; Harrington, RA; White, HD; Armstrong, PW ...
Published in: Am Heart J
July 2018

BACKGROUND: Length of stay after non-ST-segment elevation myocardial infarction (NSTEMI) continues to decrease, but information to guide duration of hospitalization is limited. METHODS: We used landmark analyses, in which the landmark defined potential days of discharge, to estimate complication rates on the first day the patient would have been out of the hospital, and estimated associations between timing of discharge and 30-day and 1-year event-free survival after discharge among NSTEMI patients. RESULTS: Among 20,410 NSTEMI patients, median length of stay was 7 (4, 12) days; 3,209 (15.7%) experienced a cardiac complication on days 0 to 2 and 1,322 (6.5%) were discharged without complications during hospital days 0 to 2. At the start of day 3, 15,879 patients (77.8%) were still hospitalized without complications. Of these, 1,689 (10.6%) were discharged event-free on day 3. Adjusted event-free survival rates of death or myocardial infarction from day 4 to 30 days after among the 1,689 patients was 99.1% compared with 93.1% for the 14,190 who remained hospitalized at the end of day 3. For 1-year mortality, these rates were 98.1% and 96.4%, respectively. Among 13,334 patients hospitalized without complications at the start of day 4, 1,706 were discharged event-free that day. Adjusted survival rates among these patients, compared with those still hospitalized at the end of day 4, were 98.0% versus 93.7% for 30-day death or myocardial infarction and 97.8% versus 96.1% for 1-year mortality. CONCLUSIONS: Patients with NSTEMI who had no serious complications during the first 2 hospital days were at low risk of subsequent short- and intermediate-term death or ischemic events.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2018

Volume

201

Start / End Page

103 / 110

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Thrombolytic Therapy
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Patient Discharge
  • Non-ST Elevated Myocardial Infarction
  • Myocardial Revascularization
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Rymer, J. A., Tempelhof, M. W., Clare, R. M., Pieper, K. S., Granger, C. B., Van de Werf, F., … Newby, L. K. (2018). Discharge timing and outcomes after uncomplicated non-ST-segment elevation acute myocardial infarction. Am Heart J, 201, 103–110. https://doi.org/10.1016/j.ahj.2018.04.010
Rymer, Jennifer A., Michael W. Tempelhof, Robert M. Clare, Karen S. Pieper, Christopher B. Granger, Frans Van de Werf, David J. Moliterno, et al. “Discharge timing and outcomes after uncomplicated non-ST-segment elevation acute myocardial infarction.Am Heart J 201 (July 2018): 103–10. https://doi.org/10.1016/j.ahj.2018.04.010.
Rymer JA, Tempelhof MW, Clare RM, Pieper KS, Granger CB, Van de Werf F, et al. Discharge timing and outcomes after uncomplicated non-ST-segment elevation acute myocardial infarction. Am Heart J. 2018 Jul;201:103–10.
Rymer, Jennifer A., et al. “Discharge timing and outcomes after uncomplicated non-ST-segment elevation acute myocardial infarction.Am Heart J, vol. 201, July 2018, pp. 103–10. Pubmed, doi:10.1016/j.ahj.2018.04.010.
Rymer JA, Tempelhof MW, Clare RM, Pieper KS, Granger CB, Van de Werf F, Moliterno DJ, Harrington RA, White HD, Armstrong PW, Lopes RD, Mahaffey KW, Newby LK. Discharge timing and outcomes after uncomplicated non-ST-segment elevation acute myocardial infarction. Am Heart J. 2018 Jul;201:103–110.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2018

Volume

201

Start / End Page

103 / 110

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Thrombolytic Therapy
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Patient Discharge
  • Non-ST Elevated Myocardial Infarction
  • Myocardial Revascularization
  • Middle Aged