Early discharge (within 24–72 h) in low-risk AMI patients treated with PCI: feasibility and safety—Hajj study

Abstract

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.

Safety of Early Discharge Among Low-Risk Patients After Primary Percutaneous Coronary Intervention: An Updated Systematic Review and Meta-Analysis

“…This follow-up activity aims to determine and evaluate the intervention provided, namely ED. The follow-up process was carried out in <1 month, 18 , 19 one month, 7 , 17 , 19–26 3 months, 27 , 28 6 months, 15 and there are also up to 1–2 years. 19 , 25 …”

Perspektif Kesehatan Matra dalam Manajemen Penyakit Tidak Menular pada Jemaah Haji: Tinjauan Literatur

“…Program discharge planning pada pasien infark miokard penting dilakukan pada keluarga maupun pasien dalam mempersiapkan kepulangan pasien untuk meminimalisir terjadinya readmission (Megasari, 2022). Penelitian yang dilakukan oleh Khaled et al (2020) terkait kelayakan pemulangan dini pada pasien infark miokard akut selama periode haji 2018-2019, menunjukkan hasil bahwa pasien yang dipulangkan lebih awal memiliki kriteria resiko komplikasi yang rendah dan tidak adanya komorbid sehingga aman dipulangkan dini. Adanya pemulangan dini pada pasien infark miokard akut dengan kondisi tersebut akan menguntungkan pihak pasien maupun rumah sakit.…”

“…Pemulangan dini ini akan mengurangi biaya perawatan, meningkatkan kepuasan pasien, meningkatnya ketersediaan bed seiring dengan cepatnya siklus pasien yang dipulangkan, serta tidak akan mengurangi kesempatan jemaah dalam menyelesaikan ibadah haji. Program pemulangan dini pada pasien infark miokard akut dapat dikatakan berhasil karena setelah dilakukan follow up selama 15 hari didapatkan 95% pasien tidak ada keluhan gejala dan tidak tercatat adanya kematian sejak pasien dipulangkan (Khaled et al, 2020). Terlaksananya program pemulangan pasien dengan cepat dan aman akan diikuti dengan peningkatan kualitas manajemen kasus pada pasien AMI.…”

Cuidados postintervención cardiovascular percutánea. COMECITE

“…Same-day discharge [39][40][41][42] or 2. early discharge (24 to 72 hours). 43,44 For the first group, the hospital would have lounge facilities or a similar hospital area. For the second group, the hospital ward is enough (Figure 1).…”